TREATMENT OF ACUTE CHOLECYSTITIS EARLY VS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY- A RANDOMIZED STUDY

DR. SOUMITRA CHANDRA; DR. SURESH KUMAR RULANIYA; DR. PRAKASH KUMAR; DR. ARNAB NAHA; DR. DEBARSHI JANA

Volume : VII, Issue : VIII, August - 2018

TREATMENT OF ACUTE CHOLECYSTITIS EARLY VS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY- A RANDOMIZED STUDY

Dr. Soumitra Chandra, Dr. Suresh Kumar Rulaniya, Dr. Prakash Kumar, Dr. Arnab Naha, Dr. Debarshi Jana

Abstract :

Background:Laparoscopic Cholecystectomy is the treatment for acute cholecyctitis but timing (early and delayed) is controversial. The aim of our prospective, comparative study is to compare relative merits and demerits of early and delayed Laparoscopic Cholecystectomy which was designed in our institution.

Materials and Methods:The study was a prospective, comparative, randomised study and Subjects were selected from patients coming to the OPD and emergency of our department from Fab 2017 to March 2018 with total 100 sample size. Sampling Techniques by the help of computer generated random numbers by the process of randomization.

Results: Mean operative time for group I and group II were 51.4 � 16.93, 72.0 � 25.25 respectively. This difference was again found to be statistically significant. Mean post-operative stay in group I was found to be 2.16 � 1.78, while in group II was 3.20 � 2.96. This difference was found to be statistically significant. In group I, 10/50 (20%) of patients suffered from shoulder pain, 4/50 (8%) had wound infection pest surgery, 1/50 (2%) suffered from UTI, 2/50 (4%) experienced post-operative haemorrhage, post-operative bile leak noticed in 1/2 (2%) of cases. The incidence of above complications were 12/50 (24%). 2/50 (4%), 2/50 (4%), 1/50 (2%) respectively in the delayed group. These differences were found to be statistically not significant. 3/50 (6%) of patients in both groups were re admitted for management of complications.

Conclusion:Early Lap cholecystitis for acute cholecystitis is feasible and safe. Early cholecystectomy is superior to delayed surgery in terms of post operative and overall hospital stay with no increased requirement for readmission. Furthermore, a reduction of total hospital stay is a major economic benefit to the current health care system. We recommended that early Lap cholecystectomy should be the procedure of choice in treating acute cholecystitis.