[Laparoscopic cholecystectomy in acute cholecystitis].
In a 18 month period 19 patients (4.7%) out of 400 affected by acute cholecystitis underwent laparoscopic cholecystectomy. In 18 cases the diagnosis was preoperative on clinical signs or ultrasound scan basis. Intraoperative and histologic confirm was obtained in all cases. Mean age was 44.9, 11 were males and 8 females. The procedure resulted longer and more difficult compared to the global series of the same period: 90 min. versus 56 min. respectively, with a difficulty score higher than 4 in 89% of cases versus 40% of the global series. Furthermore, in 56% of cases versus 23.3% of the global series an intraoperative contamination from gallbladder content was recorded. Nevertheless, only 1 (5%) minor complication was observed, in the form of omphalitis, which recovered in 2 days. Therefore, discharge was possible in average within 4 days, excluding the first two cases operated, respectively discharged in 5th and 7th p.o. day as a precautionary measure. Early coelioscopic cholecystectomy is safe and effective, if carried out by well trained surgeons, even in acute cholecystitis.
Croce
E
E
Centro di Chirurgia Laparoscopica e Mini-invasiva, Ospedale Fatebenefratelli e Oftalmico, Milano.
Azzola
M
M
Golia
M
M
Palazzini
G
G
D000208:Acute Disease; D000328:Adult; D002763:Cholecystectomy / Q000379:methods*; D002764:Cholecystitis / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications