Propensity score-matching analysis of the efficacy of late cholecystectomy for acute cholecystitis

Am J Surg. 2017 Aug;214(2):262-266. doi: 10.1016/j.amjsurg.2017.01.015. Epub 2017 Jan 10.

Abstract

Background: Urgent cholecystectomy within 72 h from symptom onset is recommended. We assessed the feasibility of performing late cholecystectomy (4-7 days from symptom onset) for acute cholecystitis.

Methods: One hundred sixty-four patients with grades 1 and 2 cholecystitis, who underwent urgent cholecystectomy within 7 days from symptom onset between June 2011 and June 2015 were enrolled. One hundred thirteen patients underwent operation within 72 h from symptom onset (early operation group), and 51 underwent operation between 4 and 7 days (late operation group). Surgical outcomes and postoperative complications were analyzed using propensity score-matching analysis.

Results: The rate of conversion, intraoperative bleeding, and complications were comparable between the groups. After a one-to-two propensity score-matched analysis was performed, outcomes of the late operation group were not inferior to those of the early operation group.

Conclusion: Late cholecystectomy was acceptable for treating grades 1 and 2 acute cholecystitis.

Keywords: Acute cholecystitis; Cholecystectomy; Complications; Late phase; Propensity score.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cholecystectomy*
  • Cholecystitis, Acute / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult