[Laparoscopic cholecystectomy performed in 235 cases of cholecystitis with impacted gallstones]

During the past 2 years, 235 cases of cholecystitis with impacted gallstones were treated with laparoscopic technique. There were 221 chronic cases and 14 acute cases accounting altogether for 15.19% of a total of 1475 patients undergoing laparoscopic cholecystectomy during the same period. As a result, 9 of these patients were converted to open surgery. Severe adhesion around the gallbladder or/and in the Calot triangle in 7, acute impacted gallstone, gallbladder necrosis along with obscure anatomy in the calot triangle in 1, and gallstone impacted at the junction of the common hepatic and cystic duct in 1 were observed. Conversion rate was 3.8%. Postoperative bile leakage developed in 2 cases and healed spontaneously. There were no intraperitoneal sepsis and perioperative death in our patients. The diagnosis, classification, and management for acute or chronic impacted gallstone are discussed.