Early laparoscopic cholecystectomy during acute cholecystitis seems safe and shortens the total hospital stay .
BACKGROUND Gallstones are present in about 10 % to 15 % of the adult western population .
Between 1 % and 4 % become symptomatic in a year .
Cholecystectomy for symptomatic gallstones is mainly performed after the acute cholecystitis episode settles because of the fear of higher morbidity and conversion from laparoscopic cholecystectomy to open cholecystectomy during acute cholecystitis .
OBJECTIVES The aim was to compare the early laparoscopic cholecystectomy ( less than seven days of onset of symptoms ) versus delayed laparoscopic cholecystectomy ( more than six weeks after index admission ) with regards to benefits and harms .
Postcholecystectomy biliary leaks in the laparoscopic era: risk factors, presentation, and management. McGill Gallstone Treatment Group.
BACKGROUND The management of  bile leaks  has evolved in the laparoscopic era . This study characterizes risk factors for their developmental and their clinical course and management . METHODS Data on a cohort of patients who developed bile leaks after cholecystectomy in the laparoscopic era  were gathered prospect ively and retrospectively from an ongoing surgical data base and following a review of hospital charts . RESULTS Sixty-four patients ( mean age 56 + /- 17.1 years , 72 % women ) were included over a 5-year study period . The incidence of leaks was 1.1 % among patients entered in a  laparoscopic cholecystectomy data base . Intraoperative complications were encountered in 36 % . Rates of intraoperative complication and conversion to open surgery were greater among patients who developed leaks ( 5.2 % vs 0.6 % and 33 % vs 6.3 % , respectively , p < 0.00001 ) . Patients presented 5.3 + /- 4.2 days following surgery with abdominal pain ( 89 % ) , fever ( 74 % ) , and tenderness ( 81 % ) . Ultrasound diagnosed a suspected leak in 73 % , which ERCP showed as originating from the cystic duct stump in 77 % . Biliary obstruction was noted in 20 ( 31 % ) patients ( 14 with stones ) . Treatments included percutaneous ( 13 % ) , endoscopic ( 28 % ) , primary or secondary operative procedures ( 14 % ) , or a combination thereof ( 45 % ) . CONCLUSION A complication at laparoscopic cholecystectomy increases the likelihood of a subsequent bile leak . Most patients present early with a patent cystic duct stump in the absence of biliary obstruction . Endoscopic therapy is successful in the majority of cases , but otherwise percutaneous or operative procedures may be needed
Early laparoscopic cholecystectomy during acute cholecystitis seems safe and shortens the total hospital stay .
BACKGROUND Gallstones are present in about 10 % to 15 % of the adult western population .
Between 1 % and 4 % become symptomatic in a year .
Cholecystectomy for symptomatic gallstones is mainly performed after the acute cholecystitis episode settles because of the fear of higher morbidity and conversion from laparoscopic cholecystectomy to open cholecystectomy during acute cholecystitis .
OBJECTIVES The aim was to compare the early laparoscopic cholecystectomy ( less than seven days of onset of symptoms ) versus delayed laparoscopic cholecystectomy ( more than six weeks after index admission ) with regards to benefits and harms .