title: Difficult cholecystectomies: validity of the laparoscopic approach.
abstract: OBJECTIVE
  The aim of this work was to determine the outcome of "difficult cholecystectomy" caused by acute cholecystitis or cirrhosis, in relation to the number of conversions, principal biliary duct injuries, the length of the operation, and of postoperative hospitalization.
  
  
  METHODS
  From 1998 through 2000, 51 patients, 38 females and 13 males, underwent cholecystectomy for acute cholecystitis and cholecystitis associated with liver cirrhosis; the average age was 58.8 years (range, 24 to 86 years). No preoperative selection was made for video laparoscopic treatment. An open laparoscopy was performed in all cases.
  
  
  RESULTS
  All interventions were completed by video laparoscopy. No injury of the major bile ducts occurred in the 51 cases. The average time of operation was 110 minutes. The average length of hospitalization was 3 days.
  
  
  CONCLUSIONS
  This study demonstrates that the results after "difficult laparoscopic cholecystectomy" are comparable to those after "open cholecystectomy." Difficult cholecystectomy executed with video laparoscopic methodology is safe and effective if performed with appropriate equipment and by experienced surgeons.
authors: University of Foggia, Division of General Surgery, Ospedali Riuniti Hospital, Foggia, Italy. tizpv@tiscali.it
authors: Vincenzo
authors: V
authors: Neri
authors: Antonio
authors: A
authors: Ambrosi
authors: Giuseppe
authors: G
authors: Di Lauro
authors: Alberto
authors: A
authors: Fersini
authors: Tiziano Pio
authors: TP
authors: Valentino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D016896:Treatment Outcome