Laparoscopic cholecystectomy for acute cholecystitis.
BACKGROUND
The aim of this study is to present our experience and results with performing laparoscopic cholecystectomy for acute cholecystitis evaluating the effect of timing of surgery and the influence of the various types of gallbladder inflammation on patient outcome.


METHODS
The patients were separated in three groups according to the time between the onset of symptoms and the operation: the "early" group was defined as laparoscopic cholecystectomy completed in the first 72 h after the onset of the symptoms, the "intermediate" group from 4 to 7 days, and the "delayed" group with symptoms lasting more than 8 days.


RESULTS
Two hundred twenty-five patients underwent laparoscopic cholecystectomy. There were 115 patients who underwent "early" surgery; 70 patients underwent "intermediate" surgery, and 70 patients underwent "delay" surgery. The total number of converted cases was 32 (12.5%). There were 124 cases of acute cholecystitis, 53 cases of gangrenous cholecystitis, 27 cases of hydrops, and 51 cases of empyema. There was no significant difference in complication rate, mortality, and postoperative hospital stay.


CONCLUSIONS
Laparoscopic cholecystectomy can be accomplished safely in most patients with acute cholecystitis. The timing of surgery has no clinical relevant effect on conversion rates, operative times, morbidity, and postoperative hospital stay.
Popkharitov
Angel Iliev
AI
Department of Surgery, Neurosurgery and Urology, Medical Faculty, Thracian University, Stara Zagora, Bulgaria. popkharitov@abv.bg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D013997:Time Factors; D055815:Young Adult