Experience of laparoscopic cholecystectomy in acute cholecystitis

ABSTRACT

A prospective evaluation of laparoscopic cholecystectomy in cases of acute cholecystitis is presented. Consecutive 55 histologically confirmed cases of acute cholecystitis in all age groups were included in the study. The criteria for exclusion were choledocholithiasis and inability to withstand general anaesthesia. In 12.73% cases conversion to open cholecystectomy was resorted. There was no delayed re-operation. Female to male ratio was 2.931 and age ranged from 23 to 80 years with a mean of 47.27 years. Largest number of patients were in their fifth decade, however 16.34% patients were over sixty years of age. Sensitivity of ultrasonography, clinical features and laparoscopy in accurate diagnosis of acute cholecystitis was 80%, 90.91% and 96.36% respectively. Empyema was found in 30.91% pericholecystic abscess [9.09%] and patchy gangrene in 7.27% cases. Operating time ranged from 35 minutes to 120 minutes with an average of 85 minutes. Average postoperative stay in patients with laparoscopic cholecystectomy was 43.5 hours as compared to 68.57 hours when converted to open procedure. After laparoscopic cholecystectomy 4 patients [8.3%] developed 5 complications including prolonged biliary leakage in one patient. However, there was no biliary injury or mortality in the series. Laparoscopic cholecystectomy appears safe option in acute cholecystitis provided a low threshold of conversion to open cholecystectomy is maintained