title: Usefulness of Laparoscopy in Gangrenous Cholecystitis.
abstract: BACKGROUND
  Gangrenous cholecystitis (GC) is a rare and severe condition requiring immediate cholecystectomy. The aim of this study was to compare outcomes of laparoscopic cholecystectomy with open cholecystectomy in patients with GC.
  
  
  METHODS
  The records of 278 patients with GC who underwent cholecystectomy, for acute cholecystitis were compared with those of 531 patients with nongangrenous cholecystitis. In patients with GC, the outcomes of laparoscopic cholecystectomy were also compared with the outcomes of open cholecystectomy.
  
  
  RESULTS
  Multivariate analysis demonstrated an independent association of diabetes mellitus, temperature, muscle rigidity on examination, white cell blood count, gallbladder wall thickening, gallbladder wall interruption, detection of pericholecystic exudate on ultrasonography, with the development of acute GC. The rate of conversions in the GC group was higher than in nongangrenous cholecystitis group. In patients with GC morbidity did not differ between patients operated using laparoscopic technique or open technique. Total and postoperative hospital stays were shorter in patients operated using laparoscopic technique.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy is a safe procedure in patients with GC. Although the conversion rate to open surgery was elevated, the number of other complications was comparable to open surgery. Laparoscopic cholecystectomy significantly reduced total hospital stays and medical costs.
authors.affiliation: Department of Surgery, Mohamed Tahar Maamouri Hospital, Faculty of Medicine of Tunis, University El Manar, Nabeul, Tunisia.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Bouassida
authors.forename: Bassem
authors.initials: B
authors.lastname: Mroua
authors.forename: Slim
authors.initials: S
authors.lastname: Zribi
authors.forename: Obeid
authors.initials: O
authors.lastname: Belghith
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Mighri
authors.forename: Hassen
authors.initials: H
authors.lastname: Touinsi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005704:Gallbladder / Q000473:pathology*; D005734:Gangrene / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult