title: Emergent laparoscopic cholecystectomy for acute acalculous cholecystitis revisited.
abstract: OBJECTIVE
  To compare the safety of emergent laparoscopic cholecystectomy for acute acalculous cholecystitis (AAC) with surgery for acute calculous cholecystitis (ACC).
  
  
  METHODS
  We retrospectively reviewed the perioperative records of 111 patients who underwent emergent laparoscopic cholecystectomy for acute cholecystitis under the care of the Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, between January 2010 and April 2014. Patients were divided into the AAC group (27 patients) and the ACC group (84 patients), and their perioperative outcomes were compared.
  
  
  RESULTS
  Patients in the AAC group had significantly higher disease severity and American Society of Anesthesiologists physical status scores (p = 0.001 and 0.037, respectively), lower blood hemoglobin and albumin concentrations (p = 0.0005 and 0.017, respectively), and lower hematocrit and platelet count (p < 0.0001 and 0.040, respectively) than those in the ACC group. When we compared perioperative outcomes, we also found that patients in the AAC group were more likely to have received a blood transfusion (p = 0.002) and to have required conversion to open surgery (p = 0.008). There were no significant differences in morbidity, mortality or length of hospital stay.
  
  
  CONCLUSIONS
  Early laparoscopic cholecystectomy is safe in acute acalculous as well as acute calculous cholecystitis.
authors.affiliation: Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ueno
authors.affiliation: Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakashima
authors.affiliation: Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Higashida
authors.affiliation: Department of Hepatology and Pancreatology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Hepatology and Pancreatology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hino
authors.affiliation: Department of Pathology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Irei
authors.affiliation: Department of Pathology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan. mnakamura@med.kawasaki-m.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D042101:Acalculous Cholecystitis / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D041881:Cholecystitis, Acute / Q000601:surgery*; D015331:Cohort Studies; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Acute acalculous cholecystitis; Early laparoscopic cholecystectomy; Emergent operation; Short-term clinical outcomes; Ultrasound scissors