title: [Development of the surgical approach to acute cholecystitis in an emergency surgical unit].
abstract: OBJECTIVE
  The application of the laparoscopic technique in acute cholecystitis is still subject to controversy. The aim of this study is to asses the applicability, safety, benefits and complications of the laparoscopic approach in patients with acute cholecystitis, as well as the development of this technique in the emergency surgery department of a tertiary hospital, compared to laparotomy.
  
  
  METHODS
  The study consisted of 354 patients with acute cholecystitis syndromes operated either by open or laparoscopic surgery, during the years 2006 to 2009.
  
  
  RESULTS
  The laparoscopic method was used in 253 patients, and 101 by the open route, with the slight majority being male (57.67%) and with a mean age of 62.83 years. The number of laparoscopic cholecystectomies increased from 60% in 2006, to 79% in 2009. The mean hospital stay (including those with and without complications) was shorter using the laparoscopic approach, compared to open surgery (showing a difference of approximately 6 days). The postoperative complications in laparoscopy during the four years studied decreased from 21.42 to 11.3%. The local and general complications were significantly associated with time since the start of the acute symptoms and the surgery, as well as the histopathological state of the gall bladder.
  
  
  CONCLUSIONS
  The laparoscopic approach continues to play an increasing role in the treatment of this disease, becoming the main surgical option in our hospital.
authors.affiliation: Cirugía General y del Aparato Digestivo del Hospital Universitario Virgen Macarena, Sevilla, España. milu_1983@hotmail.com
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Reyes Díaz
authors.forename: Juan Antonio Díaz
authors.initials: JA
authors.lastname: Milanés
authors.forename: José Antonio López
authors.initials: JA
authors.lastname: Ruiz
authors.forename: Francisco Del Río
authors.initials: Fdel R
authors.lastname: Lafuente
authors.forename: Javier
authors.initials: J
authors.lastname: Valdés Hernández
authors.forename: Laura Sánchez
authors.initials: LS
authors.lastname: Moreno
authors.forename: José López
authors.initials: JL
authors.lastname: Pérez
authors.forename: Fernando Oliva
authors.initials: FO
authors.lastname: Mompeán
mesh_terms: D002763:Cholecystectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000706:statistics & numerical data; D041881:Cholecystitis, Acute / Q000601:surgery*; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies