Indications and surgical methods of laparoscopic cholecystectomy for acute cholecystitis / 中国微创外科杂志

ABSTRACT

Objective To investigate indications and surgical methods of laparoscopic cholecystectomy (LC) in the management of acute cholecystitis. Methods Clinical data of 78 cases of acute cholecystitis treated by LC were retrospectively analyzed. Stones were impacted in the neck of the gallbladder in 65 cases. An anterograde cholecystectomy was performed in 47 cases, a retrograde cholecystectomy in 19 cases, and a subtotal cholecystectomy, in 12 cases. Results The laparoscopic operation was successfully accomplished in 74 cases, whereas a conversion to open surgery was required in 4. An abdominal drainage was used in 61 cases and was removed 24~48 hours after the surgery. The mean length of postoperative hospital stay was 4.8 days. Postoperative biliary leakage occurred in 1 case because of an injury of the common hepatic duct by electrocauterization, which was cured by open surgery with T-tube drainage for 6 months. No other severe complications happened. Conclusions With the exception of a small number of cases (such as Mirrizi's syndrome type Ⅲ or Ⅳ, the gallbladder totally or partially embedded in the liver, or suspected carcinoma of gallbladder), anterograde, retrograde or subtotal laparoscopic cholecystectomy can be safely applied to these with acute cholecystitis within 48 hours after the onset.