Comparative Study of Outcomes in Very Early and Early Laparoscopic Cholecystectomy in Cases of Acute Cholecystitis

Background: Acute cholecystitis is a common surgical emergency. While early laparoscopic cholecystectomy (LC) is well-established, there is ongoing debate regarding the optimal timing within the early window. This study compared outcomes between very early LC (<3 days from symptom onset) and early LC (3–10 days from symptom onset) in patients with acute cholecystitis. Materials and Methods: An observational clinical study was conducted over 19 months at People’s Hospital, Bhopal, involving 80 patients with acute cholecystitis who met predefined inclusion and exclusion criteria. Patients were allocated to Very Early LC (n=42) or Early LC (n=38) groups based on timing of surgery. Demographic, clinical, laboratory, ultrasound, intraoperative, and postoperative parameters were recorded and compared. Statistical analysis was performed using SPSS version 25.0. Results: Baseline demographic, clinical presentation, and ultrasound findings were comparable between groups. Direct bilirubin was significantly higher in the Early LC group (0.50 ± 0.4 mg/dL vs 0.36 ± 0.10 mg/dL, p=0.04). Very Early LC was associated with significantly shorter operative time (30 ± 15 vs 50 ± 20 min, p=0.001), lower intraoperative blood loss (20 ± 10 vs 30 ± 20 mL, p=0.0074), fewer cases of difficult Calot’s dissection (9% vs 23%, p=0.02), and shorter hospital stay (4.0 ± 1.5 vs 6.0 ± 3.0 days, p=0.01). Postoperative pain scores were significantly lower in the Very Early LC group (4.39 ± 0.31 vs 5.65 ± 1.46, p=0.001). Although overall postoperative complications were lower in Very Early LC (16% vs 30%), the difference was not statistically significant (p=0.09). Conclusion: Very early LC provides significant benefits in operative efficiency, reduced intraoperative difficulty, and shorter recovery compared to early LC, without increasing complication rates. These findings support prioritizing very early surgical intervention in acute cholecystitis to optimize patient outcomes and healthcare resource utilization. Keywords: Cholecystitis, Laparoscopic Cholecystectomy, Surgical Timing, Very Early Surgery, Postoperative Outcomes.