EP 514 Early vs Late Laparoscopic Cholecystectomy in Gallbladder Disease: Outcomes with Imputed Symptom Onset and Confidence Intervals
Emer McCarron, Zeeshan Saboor Ahmed, Khurram Rais, Manon Williams, Peter Osuala, EiEi KhineAbstract
Background
Early laparoscopic cholecystectomy (LC) within 72 hours of symptom onset is recommended for acute gallbladder disease, but real-world onset documentation is often incomplete. We assessed whether timing influences outcomes in patients with cholecystitis, acute cholecystitis, symptomatic gallstones, or biliary colic.
Methods
Retrospective single-centre cohort. Timing was calculated from onset of symptoms (OOS) to operation; missing OOS was imputed as 48 hours before surgery. Primary open procedures were excluded; conversions retained. Patients were grouped as Early (<72 h) or Late (>72 h). Outcomes: operative duration (mean ± SD), length of stay (LOS; median [IQR]), postoperative complications, and conversion to open. Binary outcomes include 95% CIs (Wilson method). Continuous outcomes compared with Welch’s t-test and Mann–Whitney U.
Results
158 patients (Early n=97, Late n=61).Operative duration: Early 1.88 ± 0.63 h vs Late 1.96 ± 0.69 h (p=0.462).LOS: Early 4.0 days (IQR 3.0–6.8, n=54) vs Late 5.0 days (IQR 3.2–7.8, n=26) (p=0.176).Post-op complications: Early 8/97 (8.2%, 95% CI 4.2–15.4) vs Late 3/61 (4.9%, 95% CI 1.7–13.5).Conversion to open: Early 1/97 (1.0%, 95% CI 0.2–5.6) vs Late 0/61 (0.0%, 95% CI 0.0–5.9).
Conclusions
Early LC did not significantly affect operative time, LOS, complications, or conversion rates compared with late surgery. A modest, non-significant trend toward shorter LOS was observed. Larger, adjusted studies are warranted.