Laparoscopic cholecystectomy in acute cholecystitis could be a safe procedure?

ABSTRACT

The past years have been a time of great excitement in laparoscopic surgery and laparoscopic cholecystectomy in particular. 69 patients suffering from acute calcular cholecystitis subjects to laparoscopic procedure were included in this study. Patients were collected at random, 41 patients were women and 28 were men, patients aged 26-84 years with a mean age 58.5 years. Laparoscopic cholecystectomy could be done in 54 cases [78.26%]. Cholecystectomy was conducted safely in 42 cases [60.87%]. In 18 cases laparoscopic cholangiography through cannulation of gallbladder or cystic duct was induced and it was successful in 14 cases and laparoscopic cholecystectomy was proceeded in 12 cases [17.39%]. Minor complications occurred in 9 cases and included bile leakage in 4 cases, umbilical sepsis in 2 cases and 3 cases of abdominal wall hematoma. Major complication in the form of duodenal perforation occurred in one case. In 15 patients [21.73%] the operation was converted into open procedures because of difficult or unclear anatomy in 8 cases, failed cholangiography in 4 cases, cholangiographic evidences of common bile duct stones in 2 cases, cystic artery bleeding in one case and perforated duodenum in another case. No mortality occurred in this group of patients. With adequate experience, proper judgment at selection of cases of acute cholecystitis suitable for laparoscopic cholecystectomy and with the help of operative laparoscopic cholagiography and endoscopic sphincterotomy, laparoscopic cholecystectomy could be a safe procedure