WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Dr. Qusay Ahmed Njati Younus

ABSTRACT

Background: Acute cholecystitis is one of the most common surgical emergencies and laparoscopic cholecystectomy remains the definitive treatment. However, the optimal timing of surgery continues to be debated, with ongoing discussion regarding the benefits and risks of early versus delayed cholecystectomy. Objectives: To compare the surgical outcomes and postoperative complications of early versus delayed cholecystectomy in patients with acute calculous cholecystitis treated at Al Salam Teaching Hospital, Mosul. Methods: A retrospective comparative study was conducted at Al Salam Teaching Hospital, Mosul, Iraq, between July 2024 and May 2026. A total of 200 patients diagnosed with acute calculous cholecystitis were included and divided into two groups according to the timing of surgery: early cholecystectomy (n=100) and delayed cholecystectomy (n=100). Demographic characteristics, operative outcomes, postoperative complications, length of hospital stay, readmission rates, and overall surgical outcomes were analyzed. Statistical analysis was performed using SPSS version 27, and a P value of less than 0.05 was considered statistically significant. Results: The mean age of the patients was 46.0 ± 12.9 years, and females represented 60.5% of the study population, with a female-to-male ratio of 1.53:1. The mean operative time was significantly shorter in the early cholecystectomy group compared with the delayed group (68.4 ± 18.7 vs. 79.6 ± 22.3 minutes; P = 0.001). Overall postoperative complications occurred in 10.0% of patients undergoing early surgery and 20.0% of those undergoing delayed surgery (P = 0.046). The mean hospital stay was significantly shorter in the early group (3.1 ± 1.2 days) than in the delayed group (5.6 ± 2.1 days) (P < 0.001). Readmission rates were also significantly lower among patients undergoing early cholecystectomy (3.0% vs. 15.0%; P = 0.003). Multivariate logistic regression analysis identified delayed surgery (OR = 2.89, P = 0.014) and diabetes mellitus (OR = 2.11, P = 0.047) as independent predictors of unfavorable postoperative outcomes. Conclusions: Early cholecystectomy was associated with shorter operative time, reduced hospital stay, lower readmission rates, fewer postoperative complications, and better overall surgical outcomes compared with delayed cholecystectomy. Delayed surgery and diabetes mellitus were significant predictors of unfavorable postoperative outcomes. Early laparoscopic cholecystectomy should therefore be considered the preferred treatment strategy for suitable patients with acute calculous cholecystitis.

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