Abstract
Background
The aim of this study is to present our experience and results with performing laparoscopic cholecystectomy for acute cholecystitis evaluating the effect of timing of surgery and the influence of the various types of gallbladder inflammation on patient outcome.
Materials and methods
The patients were separated in three groups according to the time between the onset of symptoms and the operation: the “early” group was defined as laparoscopic cholecystectomy completed in the first 72 h after the onset of the symptoms, the “intermediate” group from 4 to 7 days, and the “delayed” group with symptoms lasting more than 8 days.
Results
Two hundred twenty-five patients underwent laparoscopic cholecystectomy. There were 115 patients who underwent “early” surgery; 70 patients underwent “intermediate” surgery, and 70 patients underwent “delay” surgery. The total number of converted cases was 32 (12.5%). There were 124 cases of acute cholecystitis, 53 cases of gangrenous cholecystitis, 27 cases of hydrops, and 51 cases of empyema. There was no significant difference in complication rate, mortality, and postoperative hospital stay.
Conclusions
Laparoscopic cholecystectomy can be accomplished safely in most patients with acute cholecystitis. The timing of surgery has no clinical relevant effect on conversion rates, operative times, morbidity, and postoperative hospital stay.
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Abbreviations
- LC:
-
laparoscopic cholecystectomy
- AC:
-
acute cholecystitis
- CBD:
-
common bile duct
- ERCP:
-
endoscopic retrograde cholangiopancreatography
- IOC:
-
intraoperative cholangiography
- SLC:
-
subtotal laparoscopic cholecystectomy
References
Lo C-M, Fan S-T, Wong J (1998) Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 227(4):461–467 April
Tzovaras G, Zacharoulis D, Liakou P, Theodoropoulos T, Paroutoglou G, Hatzitheofilou C (2006) Timing of laparoscopic cholecystectomy for acute cholecystitis: a prospective non randomized study. World J Gastroenterol 12(34):5528–5531 Sept 14
Koo KP, Thirlby RC (1996) Laparoscopic cholecystectomy in acute cholecystitis. What is the optimal timing for operation? Arch Surg 131:540–546 May
Lai RBS, Kwong KH, Leung KL, Kwok SPY, Chan ACW, Chung SCS, Lau WY (1998) Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J of Surg 85:764–767
Garber SM, Korman J, Cosgrove JM, Cohen JR (1997) Early laparoscopic cholecystectomy for acute cholecystitis. Surg Endosc 11(4):347–350 Apr
Pessaux P, Tuech JJ, Rouge C, Duplessis R, Cervi C, Arnaud JP (2000) Laparoscopic cholecystectomy in acute cholecystitis. A prospective comparative study in patients with acute vs chronic cholecystitis. Surg Endosc 14(4):358–361 Apr
Soffer D, Blackbourne LH, Schulman CI, Goldman M, Habib F, Benjamin R et al (2007) Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis? Surg Endosc 21:805–809 Dec
Lau H, Lo CY, Patyl NG, Yuen WK (2006) Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: a metaanalysis. Surg Endosc 20(1):82–87 Jan
Wang YC, Yang HR, Chung PK, Jeng LB, Chen RJ (2006) Urgent laparoscopic cholecystectomy in the management of acute cholecystitis: timing does not influence conversion rate. Surg Endosc 20(5):806–808 May
Eldar S, Sabo E, Nash E, Abrahamson J, Matter I (1998) Laparoscopic cholecystectomy for various types of gallbladder inflammation. A prospective trial. Surg Laparosc Endosc 8(3):200–207
Singer JA, Mckeen RV (1994) Laparoscopic cholecystectomy for acute or gangrenous cholecystitis. Am Surgeon 60:326–328 May
Hashizume M, MacFadyen BV (1998) The clinical management and results of surgery for acute cholecystitis. Semin Laparosc Surg 5(2):69–80 June
Lo C-M, Fan S-T, Liu C-L, Lai ECS, Wong J (1997) Early decision for conversion of laparoscopic to open cholecystectomy for treatment of acute cholecystitis. Am J Surg 173:513–517 Jun
Michalowski K, Bornman PC, Krige JEJ, Gallagher PJ, Terblanche J (1998) Laparoscopic subtotal cholecystectomy in patients with complicated acute cholecystitis or fibrosis. Br J Surg 85:904–906
Yeh C-N, Jan Y-Y, Chen M-F (2003) Laparoscopic treatment for Mirizzi syndrome. Surg Endosc 17:1573–1578
Kum Ch-K, Eypasch E, Lefering R, Paul A, Neugebauer E, Troidl H (1996) Laparoscopic cholecystectomy for acute cholecystitis: is really safe? World J Surg 20:43–49
Cox MR, Wilson TG, Luck AJ, Jeans PL, Padbury RTA, Toouli J (1993) Laparoscopic cholecystectomy for acute inflammation of the gallbladder. Ann Surg 218(5):630–634
Bingener J, Stefanidis D, Richards ML, Schwesinger WH, Sirinek KR (2005) Early conversion for gangrenous cholecystitis: impact on outcome. Surg Endosc 19(8):1139–1141 Aug
Habib FA, Kolachalam RB, Khilnani R, Preventza O, Mittal VK (2001) Role of laparoscopic cholecystectomy in the management of gangrenous cholecystitis. Am J Surg 181(1):71–75 Jan
Suter M, Meyer A (2001) A 10-year experience with the use of laparoscopic cholecystectomy for acute cholecystitis: is it safe? Surg Endosc 15(10):1187–1192 Oct
Tsushimi T, Matsui N, Takemoto Y, Kurazumi H, Oka K, Seyama A, Morita T (2007) Early laparoscopic cholecystectomy for acute gangrenous cholecystitis. Surg Laparosc Endosc Percutan Tech 17(1):14–18 Feb
Araujo-Teixeira JP, Rocha-Reis J, Costa-Cabral A, Barros H, Saraiva AC, Araujo-Teixeira AM (1999) Laparoscopy or laparotomy in acute cholecystitis (200 cases). Comparison of the results and factors predictive of conversion. Chirurgie 124(5):529–535 Nov
Koperna Th, Kisser M, Schulz F (1999) Laparoscopic versus open treatment of patients with acute cholecystitis. Hepato-Gastroenterology 46:753–757
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Popkharitov, A.I. Laparoscopic cholecystectomy for acute cholecystitis. Langenbecks Arch Surg 393, 935–941 (2008). https://doi.org/10.1007/s00423-008-0313-7
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DOI: https://doi.org/10.1007/s00423-008-0313-7