Laparascopic Cholecystectomy Outcome in Acute and Chronic Cholecystitis

Document Type : Research Paper

Authors

1 Assistant Professor of General Surgery, Hamedan University of Medical Sciences and Health Services, Besat Hospital, Hamedan, Iran

2 Medical Student and Researcher, Hamedan University of Medical Sciences and Health Services, Hamedan, Iran

3 General Practitioner,Hamedan University of Medical Sciences and Health Services, Hamedan, Iran

Abstract

Introduction
Although Laparoscopic Cholecystectomy (LC) is one of the most common elective surgeries, its indication in acute cholecystitis is controversial.
Materials and Methods
This retrospective study is comprised of 182 patients with acute or chronic cholecystitis admitted at Ekbatan and Tamin Ejtamaiee hospitals and underwent laparoscopic cholecystectomy from March 2002 to September 2006. Patients were divided into two groups: 1- patients with acute cholecystitis and 2- patients with chronic cholecystitis on the basis of surgical and pathological findings. Patients were compared for laparoscopic cholecystectomy results, complications, duration of hospital stay, and factors associated with conversion from laparoscopic cholecystectomy to open cholecystectomy.
Results
From 182 patients underwent LC, 39(21.4%) were male and 143 (78.6%) were female. The mean age of patients was 49±15.9 years (17-85 year). The mean age of patients with acute cholecystitis who underwent LC was significantly lower than those with chronic cholecystitis (p<0.05). The conversion rates was significantly higher in the acute cholecystitis group (p<0.05). Adhesion was the main reason for conversion to open surgery which was found in 16 (72.7%) patients. The conversion rate was 13.6% for adhesion plus hydrops, 9% for edema and 4.5% for pancereatic head cancer.
Conclusion
This study showed that LC is an appropriate safe method for treatment of cholecystitis and can be served as the method of choice and first line therapy for cholecystitis.

Keywords

References

1- Portincase P, Stolk MF, Van Erpecum KJ, Palasciano G, Van Berge-Henegouwen GP. Cholesterol gallstone
formation in man and potential treatment of the gallbladder motility defect. Scand J Gastroenterol 1995; 212:63-78.
2- Vogt DP. Gallbladder disease: an update on and treatment. Cleve Clin J Med 2002; 69:977-984.
3- Perissat J. Facs Laparoscopic Cholecystectomy.Am J Surg 1993:163:444.
4-Richardson WS, Fuhrman GS,Burch E,Bowen JC. Outpatient laparoscopic cholecystectomy. Outcomes of 847
planned procedures. Surg Endosc 2001; 15:193-195.
5- Sajedi P, Naghibi K, Soltani H. A randomized prospective comparison of end-tidal CO2 pressure during laparascopic
cholecystectomy in low and high flow anesthetic system. Acta Anaesthesiol Sin 2003; 41:3-5
6- Keulemans YC, Venneman NG, Gouma DJ, Van Berge Henegouwen GP. New strategies for the treatment of
gallstone disease.Scand J Gastroenterol Suppl 2002; 236:87-90.
7- Liberman MA, Phillips EH, Carrol BJ, Fallas MJ, Rosenthal R, Hiatt J. Cost-effective management of complicated
choledocholithiasis: laparascopic transcystic duct exploration or endoscopic sphincterotomy. J Am Coll Surg 1996; 182:488-494.
8- Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic
cholecystectomy: a national survey of 4292 hospitals and an analysis of 77604 cases. Am J Surg 1993; 165:9-14.
9- LO CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparascopic
cholecystectomy for acute cholecystitis. Ann Surg 1998; 227:461-467.
10- Slater K, Strong RW, Wall DR, Lynch SV. Iatrogenic bile duct injury: the scourge of laparoscopic
cholecystectomy. ANZ J Surg 2002; 72:83-88.
11- Hussain MI, Khan AF. Outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis. Saudi Med J
2006; 27:657-60.
12- Beunicardi FC, Anderson DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE. Schwartz`s Principles of Surgery.
8 th ed. McGraw Hill Co; 2005.p.1320-1325.
13- Habibi FA , Kolachalam RB, Khilnani R, Perventza O. Role of laparoscopic cholecystectomy in the management of
gangrenous cholecystitis. Am J Surg 2001; 181:71-75.
14- Al-Ghnaniem R, Benjamin IS. Long–termoutcome of hepaticojejunostomy with routine access loop formation
following iatrogenic bile duct injury. Br J Surg 2002; 89:1118-1124.
15- Madan Atul K, Aliabadi W, Shaghayegh TD, Flint LK, Steinberg SM. How earjy is early laparoscopic treatment of
acute cholecystitis. Am J Surg 2002; 183:232-236.
16- Gharaiben KI, Qasaimeh GR, Al-HeissH, Ammari F, Bani- Hani K, Al Jaberi TM, et al. Effect of timing of surgery,
type of inflammation, and sex on outcome of laparoscopic cholecystectomy for acute cholecystitis. J Laparoendosc Adv
Surg Tech A 2002; 12:193-198.
17- Pessaux P, Tuech JJ, Rouge C, Duplessis R, Cervi C, Arnaud IP. Laparoscopic cholecystectomy in acute cholecystitis. A
prospective comparative study in patients with acute vs. chronic cholecystitis. Surg Endosc 2000; 14:358-361.
18- Eldar S, Sabo E, Nash E, Abrahamson J, Matter I. Laparoscopic cholecystectomy for acute cholecystitis:
prospective trial. World J Surg 1997; 21:540-545.
medical journal of mashhad university of medical sciences
Volume 52, Issue 2 - Serial Number 2
May and June 2008
Pages 113-117

Files

Share

How to cite

Statistics