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Acute laparoscopic cholecystectomy. A case controlled study
1Department of Surgery, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland, New Zealand.
Background:
Acute laparoscopic cholecystectomy (ALC) has been performed successfully at a number of institutions. Interval laparoscopic cholecystectomy (ILC) is preferred by many surgeons because of its convenience and a perceived increased risk with acute surgery.
Methods:
A case control study was undertaken. The case group was a consecutive series of patients who underwent ALC between October 1996 and October 1997. The control group underwent ILC between March 1996 and March 1997 after at least one previous acute admission for gallstone disease.
Results:
There were 81 patients in the case group and 100 in the control group. The groups were similar in terms of age, sex, and clinical diagnosis. Operative times (70 min vs 78 min, p = 0.60), major complications (4.9% vs 2%, p = 0.41), minor complications (4.9% vs 7%, p = 0.76), and conversion rates (7. 4% vs 7%) were similar in both groups. There were no bile duct injuries in either group. The median total hospital stay was 5 days in the case group and 8 days in the control group (p < 0.0001).
Conclusions:
Acute laparoscopic cholecystectomy can be performed safely at the first hospital admission, thus reducing hospital stay and minimizing inconvenience to patients.