EP 514 Early vs Late Laparoscopic Cholecystectomy in Gallbladder Disease: Outcomes with Imputed Symptom Onset and Confidence Intervals

Abstract

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. 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. 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). 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.