Comparison of Early Vs Interval Laparoscopic Cholecystectomy for Acute Cholecystitis in Terms of Hospital Stay and Operative Time

Background: This study evaluates and compares early and interval laparoscopic cholecystectomy in terms of hospital stay, operative time, and secondary outcomes. Methods: This cross-sectional investigation took place at Lady Reading Hospital, Peshawar, between November 2023 and May 2024. A cohort of 375 patients, each presenting with acute cholecystitis, was prospectively allocated into two groups according to surgical timing. The early cohort underwent laparoscopic cholecystectomy within 72 hours of symptom onset, whereas the interval cohort received surgery 4 to 6 weeks later, following an initial period of conservative management. Comprehensive data regarding demographic variables, clinical manifestation, surgical parameters, and postoperative outcomes were systematically recorded. The statistical evaluation was executed with SPSS version 25, and a threshold of p<0.05 was employed to indicate statistical significance. Results: The results demonstrated that early laparoscopic cholecystectomy provided significant advantages. Patients in the early group experienced shorter hospital stays ‘(4 days vs. 6 days, p<0.0001) and reduced operative times (60 minutes vs. 70 minutes, p<0.0001)’. ‘The conversion rate to open surgery was also lower in the early group (10% vs. 15%, p=0.015)’. ‘While rates of complications surgical site infections and bile leaks were comparable between the two groups, early group patients recovered faster, resuming normal activities in 10 days compared to 14 days in the interval group (p<0.0001)’. Additionally, patients in the early group reported higher satisfaction scores (4.5 vs. 4.0 on a 5-point scale, p<0.0001), and treatment costs were significantly lower (5000 PKR vs. 6500 PKR, p<0.0001). Conclusions: These findings underscore the effectiveness of early laparoscopic cholecystectomy in managing acute cholecystitis. The approach not only reduces hospital stay, operative time, and treatment costs but also facilitates quicker recovery and improves patient satisfaction, without increasing the risk of complications. This evidence strongly supports the routine adoption of ‘early laparoscopic cholecystectomy as the preferred treatment approach for eligible patients, aligning with current clinical guidelines’ and enhancing overall healthcare outcomes.