[Acute cholecystitis and laparoscopic cholecystectomy. Comparison with non-complicated cholelithiasis]

Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cholelithiasis. However, the indication of the laparoscopic approach for acute inflammation of the gallbladder in unclear and further analysis of the results is required. The aim of our study was to compare the results of laparoscopic cholecystectomy after uncomplicated cholelithiasis and after acute cholecystitis. Data from 201 patients who underwent laparoscopic cholecystectomy were collected prospectively. Uncomplicated cholelithiasis was present in 149 patients and 52 individuals had acute cholecystitis. No differences in age, sex distribution or associated diseases were observed between groups. The mean operative time was significantly higher in patients with acute cholecystitis. However, no difference was observed regarding conversion rate (7.3%-7.6%) and morbidity rate (8.7%-9.6%). No mortality has occurred in any group. The average hospital stay after laparoscopic cholecystectomy was greater when acute cholecystitis was present (2.6 days-4.9 days; p < 0.01). But in this case hospitalization was shorter than after elective conversion (8 days; p < 0.001 and p < 0.05). We conclude that patients with acute cholecystitis can undergo laparoscopic cholecystectomy safely, with low morbidity and mortality rates and reduced hospital stay.