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Related Experiment Videos

Acute cholecystitis and laparoscopic cholecystectomy.

Rajeev Sinha1, Neeta Sharma

  • 1M.L.B. Medical College, Jhansi, UP India. sinharga@yahoo.com

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|May 11, 2002
PubMed
Summary

Laparoscopic cholecystectomy is effective for acute cholecystitis. However, patients with gallbladder phlegmon presenting more than 7 days after symptom onset may require different management.

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Area of Science:

  • Surgical Gastroenterology
  • Minimally Invasive Surgery
  • Gastrointestinal Disease Management

Background:

  • Acute cholecystitis is a common surgical emergency.
  • The optimal timing and approach for surgical intervention remain areas of clinical interest.

Purpose of the Study:

  • To evaluate laparoscopic cholecystectomy (LC) as the primary treatment for acute cholecystitis.
  • To compare outcomes based on the delay in seeking medical attention.

Main Methods:

  • A prospective study of 187 patients with acute cholecystitis undergoing LC.
  • Patients were grouped by time from pain onset to presentation (<3 days, 3-7 days, >7 days).
  • Analysis included operative time, hospital stay, conversion rates, and complications compared to elective LC.

Main Results:

  • Patients presenting within 3-7 days (64.17%) had higher rates of empyema (56.68%) and phlegmon (22.46%).
  • Late presenters (>7 days) experienced longer operative times (56.2 min), higher conversion rates (19.5%), and increased complications (7.3%) compared to early presenters and elective LC.
  • Early (<3 days) and intermediate (3-7 days) groups showed comparable outcomes to elective LC.

Conclusions:

  • Laparoscopic cholecystectomy is a suitable treatment for acute cholecystitis.
  • Delayed presentation (>7 days), particularly with gallbladder phlegmon, is associated with increased surgical complexity and adverse outcomes.

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