[Laparoscopic cholecystectomy for acute cholecystitis].
Laparoscopic cholecystectomy is considered the "gold standard" for the planned treatment of symptomatic cholecystolithiasis. Currently this method is used in 88% of cholecystectomy according to world database. There are evidences that laparoscopic cholecystectomy for acute cholecystitis is a quite safe method which is not connected with many complications.


OBJECTIVE
Assessment of the post-operative complication risk and hospitalization time in cases of acute cholecystitis had undergone laparoscopic cholecystectomy in comparison with classic cholecystectomy. Evaluation of non-specific inflammation process based on C-reactive protein (CRP) levels in patients' serum analysis.


METHODS
Eighty patients (58 women and 22 men) aged 22-74 (mean 53.6) were included to the study. They were undergone cholecystectomy in the Department of Gastroenterological, Oncological and General Surgery because of acute cholecystitis. There were two groups of patients: 38 patients who underwent laparoscopic cholecystectomy (group I) and 42 patients who underwent "classic" cholecystectomy (group II). No statistical differences of clinical and demographic characteristics were found in the studied groups. There was also the third group of patients distinguished in the study - the control group of 42 patients who underwent "planned" laparoscopic cholecystectomy because of chronic cholecystolithiasis. The patients were qualified for the groups I and II in accordance with randomization rule. The CRP-level of the patients' serum was evaluated in the group I and II twice: before and in the 2nd day after cholecystectomy.


RESULTS
The mean operating time was significantly shorter in the group I (laparoscopic cholecystectomy) compared with the group II ("open" cholecystectomy) 63.24 and 86.31 minutes respectively (p < 0.05) and 58 minutes in the control group. The mean period of hospital stay was also significantly shorter in the group I (4.12 day) compared with the group II (7.19), (p < 0.05), however there was no statistically significant difference between group I and the control group (3.1 day). The level of serum CRP measured before surgery was not significantly different in groups I and II although in the 2nd day after the operation statistically significant difference between studied groups was obtained: patients who were undergone laparoscopy (group I) had a lower level of serum CRP.


CONCLUSIONS
Laparoscopic cholecystectomy is a safe method of treatment both acute cholecystitis and chronic cholecystolithiasis.
Kondras
Marcin
M
Uniwersytet Medyczny w Łodzi, Klinika Chirurgii Gastroenterologicznej, Onkologicznej i Ogóllnej. Marckon@wp.pl
Wojtczak
Mariusz
M
Janiak
Adam
A
Mandryka
Yuriy
Y
Szewczyk
Tomasz
T
Modzelewski
Bogdan
B
D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002764:Cholecystitis / Q000601:surgery; D041881:Cholecystitis, Acute / Q000601:surgery*; D041761:Cholecystolithiasis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011486:Protein C / Q000032:analysis; D016896:Treatment Outcome
D011486:Protein C