title: [The lithiasic acute cholecystitis: laparoscopic treatment (About 106 cases)].
abstract: OBJECTIVE
  To assess the feasibility and the advantages of the coelioscopy in the treatment of the acute cholecystitis.
  
  
  METHODS
  From January 1996 to December 2001, 106 laparoscopic cholecystectomies for acute cholecystitis have been collected. The diagnosis of acute cholecystitis has been confirmed for all cases by the pathologic exam.
  
  
  RESULTS
  These 106 cases represent 12.4% of the set of the laparoscopic cholecystectomies practiced during the same period of survey. They are 78 women and 28 men. The mean age was 51.7 years. Eight patients (7.6%) presented an elevated operative risk (ASA III). The diagnosis of acute cholecystitis has been kept before operation in 45.3% of the cases. Major or minor intraoperative incidents have been observed in 18.9% of the cases. The rate of conversion was 17%. The reasons are dominated by the difficulties of dissection in 10 cases (55.5%) and hemorragea in 6 cases. The research of the predictive factors of conversion found 5 factors, the hyperleucocytosis, the operative delay superior to 72 hours, the adhesions around the gallbladder, the gangrenous gallbladder and the pediculitis. The post operative mortality was nul. The morbidity rate was 12.3%. Among the 13 patients who had postoperative complications, 8 were after conversion.
  
  
  CONCLUSIONS
  These results showed that the laparoscopic cholecystectomy for acute cholecystitis is an effective and good alternative with acceptable morbidity that should decrease with learning curve.
authors.affiliation: Service de Chirurgie Générale, EPS Habib Bourguiba 3029 Sfax, Tunisie.
authors.forename: Mohamed Issam
authors.initials: MI
authors.lastname: Beyrouti
authors.forename: Ramez
authors.initials: R
authors.lastname: Beyrouti
authors.forename: Nejmeddine
authors.initials: N
authors.lastname: Affes
authors.forename: Nafissa
authors.initials: N
authors.lastname: Zroud
authors.forename: Kamel
authors.initials: K
authors.lastname: Abdelmoula
authors.forename: Mohamed
authors.initials: M
authors.lastname: Azzaza
authors.forename: Abdelwaheb
authors.initials: A
authors.lastname: Hlel
authors.forename: Youssef
authors.initials: Y
authors.lastname: Dammak
authors.forename: Zied
authors.initials: Z
authors.lastname: Damak
authors.forename: Rached
authors.initials: R
authors.lastname: Derbel
authors.forename: Najla
authors.initials: N
authors.lastname: Feriani
authors.forename: Mohamed Bechir
authors.initials: MB
authors.lastname: Khlifa
mesh_terms: D000208:Acute Disease; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D002764:Cholecystitis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome