Comparative Evaluation of Laparoscopic Cholecystectomy in Acute and Chronic Cholecystectomy

Laparoscopic cholecystectomy has been performed for the management of hepatobiliary diseases. Early laparoscopic cholecystectomy (LC) was contraindication for acute cholecystitis (AC). With improvement in operative skills and advances instrumentation، LC is now a common treatment modality for AC. The objective of this study was to compare the outcome of laparoscopic cholecystectomy in acute and chronic cholecystectomy.

This retrospective study is comprised of 264 patients with acute (38 cases) or chronic (226 cases) cholecystitis admitted at Babol Medical University hospitals and underwent laparoscopic cholecystectomy from May 2006 to September 2011. Patients were diagnosed into two groups: 1- patients with acute cholecystitis and 2- patients with chronic cholecystitis on the basis of clinical، laboratory، sonographic، surgical and pathological findings. Patients were compared for laparoscopic cholecystectomy results، complications، age، gender، operation duration، early and late postoperative complications، duration of hospital stay، and factors associated with conversion from laparoscopic cholecystectomy to open cholecystectomy.

The mean age of patients was 48. 87±13. 07 years. From 264 patients underwent LC، 60 (22. 7%) were male and 204 (77. 3%) were female. Conversion to open surgery in patients with acute cholecystitis was 6 (15. 8%) cases and in those with chronic cholecystitis was 9 (4%) cases (p<0. 05). Severe adhesion and inflammation were the main reason for conversion to open surgery. Duration of hospital stay was significantly higher in patients with acute cholecystitis (1. 6±0. 9 days vs. 1. 1±0. 4) (p<0. 05). No significant difference was observed between two groups regarding early postoperative complication. Obstructive jaundice due to the cut of common bile duct was seen in a case with acute cholecystitis and 5 cases had pancreatitis due to retained stone after laparoscopic cholecystectomy in chronic cholecystitis patients.

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.