title: Does the complication rate increase in laparoscopic cholecystectomy for acute cholecystitis?
abstract: BACKGROUND
  Laparoscopic cholecystectomy (LC) has replaced open cholecystectomy for the treatment of gallbladder disease. Despite the well-accepted success of LC in chronic cholecystitis, the efficacy of this technique has been subject to some debate in acute cholecystitis (AC). This study was designed to evaluate our institution's experience with LC for AC and chronic symptomatic calculous cholecystitis (CC), based on complication and conversion rates to open surgery.
  
  
  METHODS
  The records of 1158 patients with LC from September 1991 to December 2001 were analyzed. The parameters of age, gender, early and late complication rates, and conversion rates from LC to open cholecystectomy were compared in patients with AC and CC.
  
  
  RESULTS
  During the study period, LC was performed in 1158 patients. Of these, 162 patients had AC (group 1) and 996 patients had CC (group 2). The conversion rates were 4.3% (7/162) in group 1 and 2.4% (24/996) in group 2. The complication rates were not significantly different (5.6% in group 1, 5.1% in group 2, P > 0.05). Difficulty in dissection around Calot's triangle and obscure anatomy were the main reasons for conversion to conventional open surgery. The mortality rate was 1.2% in group 1 and 0.01% in group 2.
  
  
  CONCLUSIONS
  LC appears to be a reliable, safe, and effective treatment modality for AC and CC. The surgical approach should be performed carefully because of the spectrum of potential hazards of the laparoscopic procedure. Conversion and complication rates are similar in both AC and CC groups, and improve as surgeons gain experience.
authors.affiliation: Department of Surgery, Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: Oktar
authors.initials: O
authors.lastname: Asoglu
authors.forename: Vahit
authors.initials: V
authors.lastname: Ozmen
authors.forename: Hasan
authors.initials: H
authors.lastname: Karanlik
authors.forename: Abdullah
authors.initials: A
authors.lastname: Igci
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kecer
authors.forename: Mesut
authors.initials: M
authors.lastname: Parlak
authors.forename: Ersin Selcuk
authors.initials: ES
authors.lastname: Unal
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome