A study on laparoscopic cholecystectomy for acute cholecystitis

Abstract

At Yokohama City U. hospital, following published guidlines for the treatment of acute cholangitis and cholecystitis, we perform early laparoscopic cholecystectomy (LC) for acute cholecystitis. We examined 32 patients who had undergone LC for acute cholecystitis from July 2006 to September 2009. We examined the following parameters: age, gender, time from onset of symptoms to the operation, operation time, blood loss, and postoperative hospital stay. There were 18 patients in the early LC group (Group E, within 72 hours from onset to the operation) and 14 patients in the late LC group (Group L, over 72 hours from onset to the operation). A statistically significant increase in group E was noted in the operation time (p = 0.024). No significant difference was noted in age, gender, blood loss, or post-operative hospital stay. We also classified these 32 cases into severe cases (19), intermediate cases (5), and mild cases (8). The severe cases had significant increase in the time from onset to the operation (p = 0.003) and in the operation time (p = 0.045). Postoperative complications were injury of the cystic duct and intraabodminal abscess. Both cases were in Group L, severe cases. Surgical outcomes of early LC in our institution for acute cholecystectomy were favorable, especially in Group E. The operation in Group L and in severe cases was difficult, so we must deal carefully with such cases.