{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:37:50Z","timestamp":1747183070534,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T00:00:00Z","timestamp":1567468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early laparoscopic cholecystectomy (ELC) within 72\u2009h of symptom onset is preferred for management of acute cholecystitis (AC). Beyond 72\u2009h, acute\u2010on\u2010chronic fibrosis sets in rendering surgery challenging. This study aims to compare the outcomes of ELC for AC within and beyond 72\u2009h of symptom onset by a dedicated acute surgical unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010centre retrospective study of 217 patients with AC who underwent ELC by an acute surgical unit from January 2017 to August 2018. Outcomes collected include post\u2010operative morbidity, length of hospitalization and operation duration. A subgroup analysis for the same outcomes was performed for elderly patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 217 patients, 88 were operated within 72\u2009h of symptom onset while 129 were operated beyond 72\u2009h. Twenty\u2010six patients received ELC after 7 days. There was no occurrence of bile duct injury. There was no statistical difference in conversion rates, wound infections and post\u2010operative collections. Patients receiving ELC beyond 72\u2009h had longer duration of operation (125.4 versus 116\u2009min,<jats:italic>P<\/jats:italic>= 0.035) and length of hospitalization (4.59 versus 3.09\u2009days,<jats:italic>P<\/jats:italic>= 0.001) without increase in morbidity. Patients older than 75\u2009years had a higher incidence of post\u2010operative collection (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with AC undergoing ELC by a dedicated acute surgical unit can have good outcomes even beyond 72\u2009h of symptom onset. Meticulous haemostasis should be performed for the elderly subgroup of patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15398","type":"journal-article","created":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T23:14:59Z","timestamp":1567552499000},"page":"1446-1450","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early laparoscopic cholecystectomy by a dedicated emergency surgical unit confers excellent outcomes in acute cholecystitis presenting beyond 72\u2009hours"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2248-9348","authenticated-orcid":false,"given":"Clement L. 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