A Randomized Control Trial of Clinical Outcomes in Early vs Delayed Laparoscopic Cholecystectomy in cases of Acute Calculous Cholecystitis

Gall stones are present in about 10 -15% of adult population in western world and 4-6% in Indian population. Between 1-4% of these adults become symptomatic every year, majority with biliary colic, but acute calculous cholecystitis is the main complication observed in patients of symptomatic gall stone disease and represents a major proportion of cases presenting to surgery emergency. Laparoscopic cholecystectomy is gold standard for management of symptomatic gall stone disease with complication rates of only 0.2%. However, the timing of surgery remains a topic of controversy. It can either be done early (mostly done within 72 hours of onset of symptoms) or can be delayed (conservative management followed by interval laparoscopic cholecystectomy after 6 weeks). The studies so far have shown some benefits of both creating a divide in the surgical community. Early surgery is infrastructurally more demanding and may require better skilled surgeon. However, delaying surgery exposes the people to gall stone related complications viz gall stone induced pancreatitis, cholangitis, choledocholithiasis, chronic cholecystitis, mucocele, empyema of gallbladder, gall stone ileus or even risk of gall bladder cancer. With this study we aim to see the clinical outcomes of early as well as delayed laparoscopic cholecystectomy in the management of cases of acute calculus cholecystitis and to compare which method of choice among ELC vs DLC has better outcome by comparing various parameters like duration of hospitalisation, duration of surgery, intraoperative difficulty, rate of conversion to open, post operative complications viz bile leak, surgical site infection and bile duct injury.