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Acute cholecystitis is an indication for laparoscopic cholecystectomy: a prospective study.

Bakr AA, Khalil ME, Esmat GE - JSLS (1997 Apr-Jun)

Bottom Line: We adopted the fundus-first method of dissection when safe identification of the Calot's triangle was difficult.The operation must be done early in the course of the disease.Modifications in technique should be adopted to achieve a successful outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Faculty of Medicine, University of Cairo, Egypt.

ABSTRACT

Objective: Acute cholecystitis has been considered as a relative or absolute contraindication to laparoscopic cholecystectomy. The purpose of this study is to present our experience of laparoscopic cholecystectomy as a safe and effective treatment of acute cholecystitis.

Methods: Laparoscopic cholecystectomy was offered to 34 consecutive patients with acute calculous cholecystitis, diagnosed according to strict clinical and ultrasonographic criteria. We used only three trocars. The gallbladder was routinely aspirated and sharp graspers were used. We adopted the fundus-first method of dissection when safe identification of the Calot's triangle was difficult. The cystic duct was ligated whenever necessary.

Results: The procedure was completed in 31 patients. The mean length of the laparoscopic procedure was 43 minutes, their mean hospital stay was 2.8 days. For the open group the mean length of the operative procedure was 66 minutes, while the mean hospital stay was 5.3 days. The overall morbidity rate was low.

Conclusions: The benefits of laparoscopic cholecystectomy can be safely extended to patients with acute cholecystitis. The operation must be done early in the course of the disease. The surgeon should have adequate laparoscopic experience and maintain a low threshold for conversion to open exploration. Modifications in technique should be adopted to achieve a successful outcome.

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Related in: MedlinePlus

Sonographic evidence of acute cholecystitis: pericholecystic collection.
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Related In: Results  -  Collection

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F1B: Sonographic evidence of acute cholecystitis: pericholecystic collection.


Acute cholecystitis is an indication for laparoscopic cholecystectomy: a prospective study.

Bakr AA, Khalil ME, Esmat GE - JSLS (1997 Apr-Jun)

Sonographic evidence of acute cholecystitis: pericholecystic collection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3021269&req=5

F1B: Sonographic evidence of acute cholecystitis: pericholecystic collection.
Bottom Line: We adopted the fundus-first method of dissection when safe identification of the Calot's triangle was difficult.The operation must be done early in the course of the disease.Modifications in technique should be adopted to achieve a successful outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Faculty of Medicine, University of Cairo, Egypt.

ABSTRACT

Objective: Acute cholecystitis has been considered as a relative or absolute contraindication to laparoscopic cholecystectomy. The purpose of this study is to present our experience of laparoscopic cholecystectomy as a safe and effective treatment of acute cholecystitis.

Methods: Laparoscopic cholecystectomy was offered to 34 consecutive patients with acute calculous cholecystitis, diagnosed according to strict clinical and ultrasonographic criteria. We used only three trocars. The gallbladder was routinely aspirated and sharp graspers were used. We adopted the fundus-first method of dissection when safe identification of the Calot's triangle was difficult. The cystic duct was ligated whenever necessary.

Results: The procedure was completed in 31 patients. The mean length of the laparoscopic procedure was 43 minutes, their mean hospital stay was 2.8 days. For the open group the mean length of the operative procedure was 66 minutes, while the mean hospital stay was 5.3 days. The overall morbidity rate was low.

Conclusions: The benefits of laparoscopic cholecystectomy can be safely extended to patients with acute cholecystitis. The operation must be done early in the course of the disease. The surgeon should have adequate laparoscopic experience and maintain a low threshold for conversion to open exploration. Modifications in technique should be adopted to achieve a successful outcome.

Show MeSH
Related in: MedlinePlus