Timing of laparoscopic cholecystectomy for acute cholecystitis：an analysis of 647 cases        XU Jun, ZHAI Bo, GUAN Ying-hui, et al. Department of General Surgery, the Fourth Hospital of Harbin Medical University, Harbin 150001, China
Corresponding author：XU Jun，E-mail：zaibo1999@yahoo.com.cn
Abstract    Objective    To explore the optimal timing for laparoscopic cholecystectomy (LC) in patients with acute cholecystitis.  Methods    The clinical data of 647 patients with acute cholecystitis performed laparoscopic cholecystectomy from January 2005 to January 2010 in the Department of General Surgery, the Fourth Hospital of Harbin Medical University were analyzed retrospectively. Results    According to the interval, 647 patients were divided into 3 groups. The patients in the first (n=212), second (n=238) and third (n=197) group performed LC were within 72h, during 72h-3w, and beyond 3w, respectively. There was no significant difference among 3 groups. Mean operative time and blood losses in the second group were more than those in the first and the third group significantly（P<0.05）. There was no significant difference in postoperative complication among 3 groups. Postoperative stay was 3-23 days (mean 5.5), 3-28 days (mean 7.5), 6-45days (mean 11.7) in the first, second and third group, respectively. The cost was RMB 6-19 thousand yuan (mean 11 thousand), 8-24 thousand yuan (mean 15 thousand), 15-36 thousand yuan (mean 23 thousand) in the first, second and third group, respectively. The postoperative stay and cost in the first, second and third group were increased gradually. Conclusion    The timing for LC in patients with acute cholecystitis should be within the shortest interval after onset of symptoms no matter whether the interval is within 72 h or not. On average early laparoscopic cholecystectomy is less expensive and results in better quality of life.