“How Hot Is Too Hot to Handle”: A Retrospective Analysis of “Hot Cholecystectomy” at a Tertiary Care Centre

Abstract

Introduction: Acute Cholecystitis (AC) can either be managed by Laparoscopic Cholecystectomy (LC) during an acute attack, termed as “Hot Cholecystectomy”, or can be managed conservatively with antibiotics followed by LC after 6-8 weeks, termed as “Interval Cholecystectomy”. Although various studies have now established beneficial role of emergency LC, the timing of early cholecystectomy is still a topic of debate. Aim: To study clinical outcome in patients of emergency LC and compare it with duration of attack of AC. Materials and Methods: This is a retrospective review of patients undergoing LC at Department of General and Laparoscopic Surgery of Max Superspeciality Hospital, Patparganj Industrial area, Delhi. Patients who were treated by emergency LC (Group A, n=121) were compared to those who had undergone elective LC (Group B, n=168). Emergency LC patients were divided into three groups based on duration of AC: 7 days (Group Ac, n=29). Results: Mean operative time, duration of hospital stay and use of drain was higher and rate of conversion (1.6%) and complication (1.6%) was low in Group A. Degree of inflammatory changes, duration of stay and operative time was significantly more in Group Ac as compared to Group Aa and Group Ab but conversion rate and complication rates were similar. Conclusion: Hot Cholecystectomy, although technically more challenging is safe and effective with no mortality and similar rate of complication, irrespective of the duration of symptoms.

Keywords

• acute cholecystitis
• lap cholecystectomy
• timing of cholecystectomy