Application of Laparoscopic Cholecystectomy in Acute Cholecystitis

ABSTRACT

PURPOSE: Acute cholecystitis has been a general contraindication of laparoscopic cholecystectomy, and complicated cholecystitis is a challenging disease even in open surgery. The purpose of this study is to evaluate the effectiveness and safety of laparoscopic cholecystectomy in acute and complicated cholecystitis. METHODS: We retrospectively reviewed the medical records of 233 cases treated with laparoscopic cholecystectomy for acute and complicated cholecystitis at Ewha Mokdong hospital from March 1997 to February 2001. Postoperative outcomes were compared between simple acute cholecystitis and complicated cases. The uncomplicated simple acute cholecystitis group (simple acute group) comprised 161 cases (69%) and the complicated cholecystitis group, which included hydrops, empyema, and pericholecystic abscess (complicated group), included 72 cases (31%). RESULTS: In the acute and complicated cholecystitis groups, the length of postoperative diet was 2.19 days and 2.46 days, the conversion rate was 8.07% and 8.3%, and the complication rate was 4.97% and 12.5%, respectively. There was no statistical difference for these three factors (p>0.05). The hospital stay was 6.19 days and 7.57 days, and the mean time of operation was 97.09 minute and 116.5 minute, respectively. These two factors were significantly different (p<0.05). CONCLUSION: Laparoscopic cholecystectomy was shown to be a safe and effective treatment for simple acute cholecystitis and complicated acute cholecystitis. Even in severecomplicated cholecystitis, laparoscopic cholecystectomy can be a primary treatment modality.