Outcomes of Early Laparoscopic Cholecystectomy in Cases of Acute Cholecystitis

Study Overview
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Brief Summary
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Laparoscopic cholecystectomy is the most common laparoscopic surgery performed in the world. The initial treatment of acute calculus cholecystitis includes GIT rest, intravenous fluid, correction of electrolyte imbalance from repeated vomiting, good analgesia, and intravenous antibiotics. Following this treatment, patients with uncomplicated disease are managed on outpatient basis and are called for elective laparoscopic cholecystectomy after a period of 6-8 weeks. Elective laparoscopic cholecystectomy has become the gold standard for treatment of symptomatic gallstones. However, in the early days, acute cholecystitis was a contraindication of laparoscopic cholecystectomy, and patients with acute cholecystitis were managed conservatively and discharged for re-admission in order to have elective surgery performed for the definitive treatment. Early laparoscopic cholecystectomy, within 72 hours of presentation,has been advocated because of shorter hospital stay, decreased financial costs and reduced readmission rates. Previously cited reasons against early laparoscopic cholecystectomy include the increased technical difficulties, increased risk of conversion to an open procedure (6-35 % in some studies) and increased risks of biliary complications such as bile leaks and common bile duct (CBD) injuries when operating on an inflamed gallbladder with edematous planes and distorted anatomy.

Official Title
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Outcomes of Early Laparoscopic Cholecystectomy in Cases of Acute Cholecystitis

Conditions
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Acute Calculous Cholecystitis

Intervention / Treatment
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* Procedure: Laparoscopic Cholecystectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any patient presented by Acute cholecystitis fit for lap cholecystectomy . Exclusion Criteria: Patients unfit for laparoscopic surgery such as patients with significant medical illness (ASAgrade more 3), pancreatitis and common bile duct stones

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Laparoscopic Cholecystectomy|Early laparoscopic cholecystectomy in patients with acute calcular cholecystitis|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| duration of surgery , | compare between duration of surgery between traditional elective laparoscopic cholecystectomy and early laparoscopic cholecystectomy | Intraoperative | 
| percentage of complications | compare between percentage of complications of surgery between traditional elective laparoscopic cholecystectomy and early laparoscopic cholecystectomy | 6 months | 
| morbidity | compare morbidity between traditional elective laparoscopic cholecystectomy and early laparoscopic cholecystectomy | 6 months | 
| mortality | compare mortality between traditional elective laparoscopic cholecystectomy and early laparoscopic cholecystectomy | 6 months |