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  • Title: Timing of laparoscopic cholecystectomy in acute cholecystitis.
    Author: Cheema S, Brannigan AE, Johnson S, Delaney PV, Grace PA.
    Journal: Ir J Med Sci; 2003; 172(3):128-31. PubMed ID: 14700115.
    Abstract:
    BACKGROUND: Laparoscopic cholecystectomy is associated with an increased conversion rate in acute cholecystitis. AIM: To review the operative management of symptomatic cholelithiasis with particular reference to conversion rates and morbidity for laparoscopic cholecystectomy for acute cholecystitis. METHODS: Patients undergoing cholecystectomy between January 1994 and December 1998 were recruited. Demographic details, diagnosis, duration of symptoms, treatment, outcome, post-operative stay and complications were recorded. RESULTS: Complete data were available on 482 patients (84%). Laparoscopic cholecystectomy was attempted in 120 of 132 patients (91%) with acute cholecystitis and 329 of 350 patients (94%) with non-acute gallbladder disease. Conversion rates were 27% (33/120) and 6.7% (22/329) for acute and non-acute gallbladder disease, respectively (p < 0.001 chi2 test). Relating the interval from onset of symptoms to surgery, conversion rates for acute cholecystitis were: < 3 days, 5/17 (29%); 4 to 42 days, 14/59 (23%) and > 42 days, 14/44 (31%). There were three bile duct injuries, two in the delayed (> 45 days) acute group and one in the non-acute group. CONCLUSION: Early laparoscopic cholecystectomy is the treatment of choice for acute cholecystitis, but is associated with a high conversion rate independent of the timing of surgery.
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