الفهرس 
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Abstract
Laparoscopic cholecystectomy was first introduced for elective treatment of cholelithiasis and is now being gradually accepted the treatment of choice for acute cholecystitis as well.
In this study, fourty patients had been included with acute calcular cholecystitis, they had been classified randomly into two groups, twenty patients in each group.
Group A (early group) had undergone laparoscopic cholecystectomy in the first seventy two hours (3 days) from the onset of symptoms.
Group B (delayed group) had undergone laparoscopic cholecystectomy in six to eight weeks after an initial period of conservative treatment.
Diagnosis of acute cholecystitis was based upon right hypochondrial pain and tenderness, fever, leucocytosis and ultrasonographic evidence of acute clacular cholecystitis which included thickened wall of gallbladder, presence of gall stones, and pericholecystic fluid collection.
The mean operative time in the early group was more than the mean operative time in the delayed group. The conversion rate to open cholecystectomy in the early group was less than the conversion rate in the delayed group.
The mean total hospital stay in the early group was less than the mean total hospital stay in the delayed group. Finally the overall complications in the early group was less than complications occurred in the delayed group.
from this study it is concluded that:-
• Laparoscopic cholecystectomy can be performed safely for acute cholecytitis, with acceptable low conversion and complication rates.
• Early timing of laparoscopic cholecystectomy in realtion to the onset of gall bladder inflammation may reduce the conversion rate and the total complication rate
• The morbidity of laparoscopic cholecystectomy for patients with acute cholecystitis is not reduced by a long period of initial conservative treatment. For surgeons with adequate experience, the optimal timing of laparoscopic cholecystectomy for treatment of acute cholecystitis is within 72 hours of admission.
• Early laparoscopic cholecystectomy for patients with acute cholecystitis has both medical and socioeconomic benefits and it is the preferred approach in comparison to delayed approach.