[Acute cholecystitis: is it a laparoscopic procedure?].

Abstract

One-hundred and twenty-seven consecutive patients with acute cholecystitis were operated using laparoscopic technique. Average Surgical operating time was 113 minutes with an average of 127 minutes if operative cholangiogram was performed and 96 minutes when cholangiogram was not done. Technical difficulties related to gallbladder edema and hyperemia was seen in all cases (100%), also poor exposure and difficulty in grasping the gallbladder in 87%. The most common post operative complication was the wound infection of the entry trocar port, mainly at the umbilicus. One patient with gangrenous cholecystitis and multiple organ failure died after endoscopic attempt and converted to open technique. The total number conversions was 3%. In 28% of the patients a ERCP was done with ten positive for common duct stones. Operative cholangiogram was attempted in all cases with 83% success rate and 5% where positive for common duct stones. In cases where ERCP was done postoperatively for suspicious stones, seven cases were positive. Hospital stay averaged 1.6 days. Acute cholecystitis does not contraindicate laparoscopic technique and chances of having concomitant common duct stone is 16%, for that reason radiologic studies are mandatory.