title: The outcome of early laparoscopic surgery to treat acute cholecystitis: a single-center experience.
abstract: OBJECTIVE
  The aim of this study was to prospectively assess the outcome of early laparoscopic cholecystectomy (LC) in patients with acute cholecystitis.
  
  
  METHODS
  Between July 2005 and December 2012, of 623 patients who had symptoms of acute cholecystitis during the first 72 h of hospital admission and who did not respond to non-operative treatment, 302 underwent surgical treatment. After initial treatment, all patients were followed up for 21 months on average (range: 5-27 months). The clinical, biochemical, radiological, and operative data of the 302 consecutive patients with acute cholecystitis were recorded and analyzed prospectively.
  
  
  RESULTS
  Of the 302 patients who underwent LC for acute cholecystitis, 169 were females and 133 males. Their mean ages were 47.8 years (range: 17-79 years) and 53.3 years (range: 27-90 years) respectively. Conversion to open surgery was required in 32 patients (10.5%). The mean postoperative length of hospital stay was 2 days (range: 1-3 days) in the LC group and 3 days (range: 2-6 days) in the conversion group. Significant differences between the successful LC group and the conversion group were evident terms of the length of postoperative hospitalization and gallbladder wall thickness (P=0.023). Factors associated with conversion were male gender, pericholecystic collection observed via ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm. We experienced two minor bile duct injury complications that were treated via T tube placement. No mortality occurred. Ten patients suffered infections at the incisional locations, and eight patients developed lung infections.
  
  
  CONCLUSIONS
  Early LC is safe in patients with acute cholecystitis. Male gender, pericholecystic collection determined via ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm are associated with a higher risk of conversion to open surgery.
authors.affiliation: The School of Health Care Professions Avcılar, Istanbul Gelisim University Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ciftci
authors.affiliation: Department of Internal Medicine, Istanbul Safa Hospital Yıldız Tepe Mahallesi, Bagcilar Cad., No: 108, Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abdurrahman
authors.affiliation: Department of General Surgery, Dicle University Medical School Seyrantepe, Diyarbakır, Turkey.
authors.forename: Sadullah
authors.initials: S
authors.lastname: Girgin
keywords: Acute cholecystitis; conversion to open surgery; laparoscopic cholecystectomy