title: Early laparoscopic cholecystectomy is the appropriate management for acute gangrenous cholecystitis.
abstract: Treatment of severe acute cholecystitis by laparoscopic cholecystectomy remains controversial because of technical difficulties and high rates of complications. We determined whether early laparoscopic cholecystectomy is appropriate for acute gangrenous cholecystitis. The medical records of 116 patients with acute gangrenous cholecystitis admitted to the Korea University Guro Hospital between January 2005 and December 2009 were reviewed. The early operation group, those patients who had cholecystectomies within 4 days of the diagnosis, was compared with the delayed operation group, who had cholecystectomies 4 days after the diagnosis. Of the 116 patients, 57 were in the early operation group and 59 were in the delayed operation group. There were no statistical differences between the groups with respect to gender, age, body mass index, operative methods, major complications, duration of symptoms, mean operative time (98 vs 107 minutes), or postoperative hospital stay. However, the total hospital stay was significantly longer in the delayed operation group. More patients underwent preoperative percutaneous cholecystostomy in the delayed operation group (3.5 vs 15.3%). Early laparoscopic cholecystectomy for acute gangrenous cholecystitis is safe and feasible. There is no advantage to postponing an urgent operation in patients with acute gangrenous cholecystitis.
authors.affiliation: Department of Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Gyeonggi-Do, Korea. sschoikorea@gmail.com
authors.forename: Sae Byeol
authors.initials: SB
authors.lastname: Choi
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Han
authors.forename: Chung Yun
authors.initials: CY
authors.lastname: Kim
authors.forename: Wan Bae
authors.initials: WB
authors.lastname: Kim
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Song
authors.forename: Sung Ock
authors.initials: SO
authors.lastname: Suh
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D041881:Cholecystitis, Acute / Q000473:pathology / Q000601:surgery*; D005260:Female; D005734:Gangrene; D006801:Humans; D007723:Korea; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome