Surgical Endoscopy

, Volume 7, Issue 4, pp 296–299 | Cite as

Laparoscopic cholecystectomy for acute cholecystitis

  • Robert E. Miller
  • Fred M. Kimmelstiel
Original Articles

Summary

Because laparoscopic cholecystectomy reduces hospitalization time and postoperative disability, it is being offered to an increasing number of patients with symptomatic gallstones. Nevertheless, acute cholecystitis is still considered by many surgeons to be a relative contraindication. Our standard approach has been to perform laparoscopy on all patients considered candidates for cholecystectomy. From June 1990 to October 1991, the authors personally performed laparoscopic cholecystectomy on 110 patients, 29 (26%) of whom had pathologically confirmed acute cholecystitis. Of these, nine had evidence of gangrene, perforation, or abscess formation. It was necessary to convert to open cholecystectomy in four (14%) patients. In each, inflammation or dense adhesions precluded the performance of a safe operation. The hepatorenal space was drained in 12 (41%) and cystic dust cholangiograms were performed selectively. The mean operating time was 108 min. There were no intraoperative complications. One patient developed a prolonged postoperative paralytic ileus and two patients were noted to have postoperative common duct stones. There were no deaths. The average postoperative stay for laparoscopic cholecystectomy was 2.6 days. We conclude that the advantages of laparoscopic cholecystectomy can be safely and effectively extended to the majority of patients with acute cholecystitis.

Key words

Laparoscopic cholecystectomy Acute cholecystitis 

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References

  1. 1.
    Cooperman AM (1990) Laparoscopic cholecystectomy for severe acute, embedded and gangrenous cholecystitis. J Lap Surg 1:37–40Google Scholar
  2. 2.
    Corbitt JD (1991) Laparoscopic cholecystectomy: laser versus electrocautery. Surg Laparosc Endosc 1: 85–88Google Scholar
  3. 3.
    Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, Trede M, Troidl H (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387Google Scholar
  4. 4.
    Dubois F, Icard P, Berthelot G, Levard H (1990) Coelioscopic cholecystectomy. Ann Surg 211: 60–62Google Scholar
  5. 5.
    Ferzli G, Kloss DA (1991) Laparoscopic cholecystectomy: 111 consecutive cases. Am J Gastroenterol 86: 1176–1178Google Scholar
  6. 6.
    Flowers JL, Bailey RW, Scovill WA, Zucker KA (1991) The Baltimore experience with laparoscopic management of acute cholecystitis. Am J Surg 161: 388–392Google Scholar
  7. 7.
    Graves HA, Ballinger JF, Anderson WJ (1991) Appraisal of laparoscopic cholecystectomy. Ann Surg 213: 655–664Google Scholar
  8. 8.
    Hawasli A, Lloyd LR (1991) Laparoscopic cholecystectomy, The learning curve: report of 50 patients. Am Surg 57: 542–545Google Scholar
  9. 9.
    Langenbuch C (1882) A case of extirpation of the gallbladder for chronic cholecystitis cure. Berlin Klinische, Wochenschrift 19: 725Google Scholar
  10. 10.
    McKernan JB (1991) Laparoscopic cholecystectomy. Am Surg 57: 309–312Google Scholar
  11. 11.
    McSherry CK (1989) Cholecystectomy: the gold standard. Am J Surg 158: 174–178Google Scholar
  12. 12.
    Miller RE, Kimmelstiel FM. Laparoscopic surgery: the first year on a teaching service. Surg Gynecol Obstet, in pressGoogle Scholar
  13. 13.
    Nowzaradan Y, Westmoreland JC (1991) Laparoscopic cholecystectomy: new indications. Surg Laparosc Endosc 1: 71–76Google Scholar
  14. 14.
    Perissat J, Collet D, Belliard R (1990) Gallstones: laparoscopic treatment—cholecystectomy, cholecystostomy and lithotripsy. Surg Endosc 4: 1–5Google Scholar
  15. 15.
    Perissat J, Collet D, Vitale G, Belliard R, Sosso M (1991) Laparoscopic cholecystectomy using intracorporeal lithotripsy. Am J Surg 161: 371–376Google Scholar
  16. 16.
    Peters JH, Ellison EC, Innes JT, Liss JL, Nichols KE, Lomano JM, Roby SR, Front ME, Carey LC (1991) Safety and efficacy of laparoscopic cholecystectomy. Ann Surg 213: 3–12Google Scholar
  17. 17.
    Ponsky JL (1991) Complications of laparoscopic cholecystectomy. Am J Surg 161: 393–395Google Scholar
  18. 18.
    Reddick EJ, Olsen DO (1989) Laparoscopic laser cholecystectomy. Surg Endosc 3: 131–133Google Scholar
  19. 19.
    Reddick EJ, Olsen DO, Daniell JF, Saye WB, McKernan B, Miller W, Hoback M (1989) Laparoscopic laser cholecystectomy. Laser Med Surg News 7: 38–40Google Scholar
  20. 20.
    Reddick EJ, Olsen DO, Spaw A, Baird D, Asbun H, O'Reilly M, Fisher K, Saye W (1991) Safe performance of difficult laparoscopic cholecystectomies. Am J Surg 161: 377–381Google Scholar
  21. 21.
    Salky BA, Bauer JJ, Kreel I, Gelernt IM, Gorfine SR (1991) Laparoscopic cholecystectomy: an initial report. Gastrointest Endosc 37: 1–4Google Scholar
  22. 22.
    Schirmer BD, Edge SB, Dix J, Hyser MJ, Hanks JB, Jones RS (1991) Laparoscopic cholecystectomy. Ann Surg 213: 665–677Google Scholar
  23. 23.
    Spaw AT, Reddick EJ, Olsen DO (1991) Laparoscopic laser cholecystectomy: analysis of 500 procedures. Surg Laparosc Endosc 1: 2–7Google Scholar
  24. 24.
    Terblanche J, Cuschieri A, Berci G, Reddick E, Perissat J (1990) Gallstones in the gallbladder, in and out and how? Surg Endosc 4: 127–140Google Scholar
  25. 25.
    The Southern Surgical Club (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. NEJM 324: 1073–1078Google Scholar
  26. 26.
    Unger SW, Edelman DS, Scott JS, Unger HM (1991) Laparoscopic treatment of acute cholecystitis. Surg Laparosc Endosc 1: 14–16Google Scholar
  27. 27.
    Zucker KA, Bailey RW, Gadacz TR, Imbembo AL (1991) Laparoscopic guided cholecystectomy. Am J Surg 161: 36–44Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Robert E. Miller
    • 1
  • Fred M. Kimmelstiel
    • 1
  1. 1.Department of SurgerySt. Luke's-Roosevelt Hospital CenterNew YorkUSA

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