Early Versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis: A Comparative Study

Background: Laparoscopic cholecystectomy is the gold standard for treating symptomatic cholelithiasis. However, the optimal timing of surgery in acute calculous cholecystitis remains a subject of debate. This study aims to compare early versus delayed laparoscopic cholecystectomy to determine the timing that yields better clinical outcomes. Methods: A prospective comparative study was conducted on 100 patients diagnosed with acute calculous cholecystitis at a tertiary healthcare centre in Punjab, India. Patients were randomized into two groups: Group A underwent early laparoscopic cholecystectomy within 72 hours of symptom onset, while Group B underwent delayed surgery after six to eight weeks of conservative management. Parameters analyzed included demographic data, intraoperative findings, and postoperative outcomes. Statistical analysis was performed to assess significance. Results: Both groups were comparable in age and gender distribution. Mean operative time did not show a significant difference between groups (p = 0.802). Intraoperative adhesions (24% vs. 18%) and gallbladder rupture (12% vs. 6%) were more frequent in Group A, though not statistically significant. Conversion to open surgery was higher in Group A (8%) compared to Group B (2%), but the difference was not significant (p = 0.359). No biliary tract injuries occurred in either group. Postoperative hospital stay was significantly longer in Group A (3.46 ± 0.54 days) compared to Group B (3.06 ± 0.24 days, p < 0.001). Conclusions: Early laparoscopic cholecystectomy is a safe and viable option in acute cholecystitis. However, delayed surgery may be associated with marginally lower intraoperative complications and a shorter postoperative hospital stay, suggesting potential benefits in selected cases.