The benefit and feasibility of early laparoscopic cholecystectomy  in the management of acute cholecystitis

  • Haqqi I. Razzouki Department of Surgery, Al-Yarmouk teaching hospital, Baghdad, Iraq
  • Hussein Hadi Jabbar Department of Surgery, Al-Yarmouk teaching hospital, Baghdad, Iraq

Abstract

Background: Acute cholecystitis is a common disease. The best management  in  early  cases  is  surgical,  but  the  optimal  timing  for  surgery  remains  controversial.  With  advances  and  increased  experience  in  laparoscopic  surgery,  laparoscopic  cholecystectomy  is  increasingly  being  used  in  the  management of acute cholecystitis.  Aims:  To determine the best time to operate in acute cholecytitis (early vs.  delayed) and to compare the results of laparoscopic approach with those of  open surgery in the treatment of acute cholecystitis .  Patients and Methods: This was a prospective study done at al‐Yarmouk  teaching hospital, Baghdad from Sep. 1st 2012 to Sep. 2nd 2013. All patients  admitted with a proved diagnosis of acute cholecystitis were included. The  patients  were  divided  into  two  groups,  the  first  group  had  early  cholecystectomy, laparoscopic (LC) or open (OC). The second group was  treated conservatively and delayed cholecystectomy was done. Detailed  clinical, investigative and imaging data were recorded. The details of the  operative findings, procedures and early post‐operative complications, were  documented.  Results: There were 146 patients, 82.2% female and 17.8% male. The mean age  was 40±2 years. Early surgery was done for 32.8% of patients, 58.4% as a  laparoscopic  procedure,  and  41.6%  as  an  open  procedure.  Delayed  cholecystectomy was done in 67.2% of cases. In the early group,the difficulty  was minimal in 27.2%, moderate in 39.5%, marked in 25 % and very difficult with  conversion done in 8.3%. Early complications were noticed in 4.2% in the early  LC  group,  and  8.3%  in  the  early  OC.  For  delayed  LC,  8.1%  had  early  complications vs.  6.1% for delayed OC.  Conclusions:  Early  laparoscopic  cholecystectomy  is  a  safe  and  feasible  approach to the management of acute cholecystitis.  

Published
2018-06-09
How to Cite
RAZZOUKI, Haqqi I.; JABBAR, Hussein Hadi. The benefit and feasibility of early laparoscopic cholecystectomy  in the management of acute cholecystitis. Mustansiriya Medical Journal, [S.l.], v. 13, n. 2, p. 6, june 2018. ISSN 2227-4081. Available at: <http://mmj.uomustansiriyah.edu.iq/index.php/MMJ/article/view/214>. Date accessed: 10 apr. 2020.