Abstract
The Japanese Evidence-based Guidelines for Acute Cholangitis and Cholecystitis recommend early laparoscopic cholecystectomy (LC). Emergency cholecystectomy cases for 11 years (from 1998 January to 2008 December) were reviewed retrospectively and were divided into the early part (from 1998 January to 2005 December) and the latter part (from 2006 January to 2008 December). The total number of urgent cholecystectomy cases was 85 cases, 4.6 cases on average in a year in the early part and 16 cases on average in a year in the latter part. The duration from the onset to operation was shortened (early, 2.5 to latter, 2.0 days), the complication rate decreased (early, 10.8% to latter, 8.3%), the conversion rate of LC decreased (early, 21.4% to latter, 6.9%). There were significant differences concerning blood loss and postoperative hospital stay. Blood loss decreased, 46 g for LC from 246 g for open cholecystectomy (OC) in the latter part (p<0.0001). The postoperative hospital stay was shortened to 6.8 days with of LC from 11.7 days with OC (p<0.0001). There was no significant difference about blood loss, operating time and postoperative hospital stay for the comparison between emergency and delayed LCs in the latter part. Consequently, we propose recommending that early LC should be performed as much as possible for acute cholecystitis..
