COMPARATIVE OUTCOMES OF EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY

Background: The optimal timing for laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) remains debated. This study aimed to compare clinical outcomes between Early Laparoscopic Cholecystectomy (ELC) and Delayed Laparoscopic Cholecystectomy (DLC). Methods: Aprospective comparative study was conducted over two years, including 110 patients with AC. Patients were randomized into two groups: Group A (ELC, n=55) underwent surgery during the initial admission, and Group B (DLC, n=55) underwent surgery 6-8 weeks after conservative management. Outcomes measured included operative time, intraoperative complications (bleeding, bile duct injury), conversion rates, postoperative pain, drain duration, wound infection, and total hospital stay. Results: The groups were comparable in age, gender, and clinical history. ELC was associated with a significantly longer operative time (1.30±0.0 vs. 1.0±0.07 hours, p<0.001) and a higher incidence of intraoperative bleeding (70.9% vs. 40.0%, p=0.001). Conversion rates were not significantly different (ELC 9.09% vs. DLC 5.45%). Postoperatively, the ELC group experienced significantly higher pain scores at 12, 24, and 48 hours and longer drain duration (2.05±0.13 vs. 1.01±0.15 days, p<0.001). However, the total hospital stay was significantly shorter in the ELC group (4.09±0.29 vs. 6.95±0.23 days, p<0.001). Wound infection rates were comparable. Conclusion: ELC for AC significantly reduces total hospital stay but is associated with longer operative times, increased intraoperative bleeding, and greater postoperative pain in the first 48 hours. While ELC offers resource utilization benefits, the decision should be individualized, weighing these trade-offs against the patient's clinical condition and surgical expertise.