Impact of Interval versus Early Laparoscopic Cholecystectomy in Acute Calculus Cholecystitis: A Retrospective Analysis of Surgical Outcomes

Background: The optimal timing for laparoscopic cholecystectomy in the management of acute calculus cholecystitis is debated. This study compares the outcomes of early versus interval laparoscopic cholecystectomy in patients with acute calculus cholecystitis. Methods: This retrospective analysis included 83 patients who underwent laparoscopic cholecystectomy for acute calculus cholecystitis at the Department of General Surgery, MVJMCRH, from December 2021 to November 2023. Patients were divided into two groups: early cholecystectomy (EC, n=51) and interval cholecystectomy (IC, n=32). Data on operative time, blood loss, need for ICU stay, postoperative complications, and hospital stay were collected and analysed. Results: The average duration of surgery was significantly longer in the EC group (129 ± 39.7 minutes) compared to the IC group (82 ± 22.5 minutes, p<0.0001). Mean blood loss was higher in the EC group (55 ± 12.5 ml) than in the IC group (25 ± 6.2 ml, p<0.0001). The need for ICU stay and the incidence of postoperative complications were higher in the EC group, but these differences were not statistically significant (p>0.05). The average of the total hospital stay was significantly shorter for the EC group (4.72 ± 2.57 days) compared to the IC group (index admission and admission for surgery) (8.18 ± 4.63 days, p=0.0001). Conclusions: Early laparoscopic cholecystectomy, despite longer operative times and higher blood loss, is a safe option without increasing postoperative complications resulting in reduced overall duration of hospital stay as well as total cost incurred by the patient. These findings support the recommendation for early surgical intervention in managing acute calculus cholecystitis, aligning with current guidelines and evidence from other studies. Tailoring the timing of surgery to individual patient profiles remains essential to optimize outcomes and ensure patient safety.