Evaluation of early cholecystectomy for acute cholecystitis within 10 days of onset, with arguments based on histopathological findings

Background: Histopathological findings would impact the timing of early cholecystectomy, but no reports have yet discussed. The aim of this study is to examine the feasible timing for early cholecystectomy based on both conventional clinicopathological data and histopathological findings. Methods: We retrospectively analyzed 127 patients who underwent laparoscopic cholecystectomy for acute cholecystitis (AC) at in our institutes between 2010 and 2015. Patients were categorized into two groups according to the interval between surgery and symptom onset (early, £96 h; delayed, >96 h) for comparison of clinical results. In addition, both histopathological findings and clinical results were compared between the early group (£96 h) and a sub-delayed subgroup of patients who underwent cholecystectomy at >96 h but ≦240 h. Results: No significant differences in surgical results were seen between the early group and delayed group. In terms of histopathological findings, the sub-delayed subgroup showed significant phase progression of cholecystitis compared to the early group. However, edema in the gallbladder (GB) wall was comparable in all cases operated on within 240 h, mirroring the lack of significant differences in surgical results seen between early and sub-delayed subgroups. Conclusion: Edema in the GB wall with AC is continuous within 10 days from onset, and emergency laparoscopic cholecystectomy within this period is safe and feasible.