Abstract:

Objective To investigate the rationality and timing of laparoscopic cholecystectomy (LC) for acute cholecystitis. Methods The clinical data of 837 patients with acute cholecystitis undergoing LC (LC group) and 185 patients receiving open cholecystectomy (OC) for acute cholecystitis (OC group) were retrospectively analysed. According to the time of disease onset, patients in LC group were subdivided into acute group (n=679, time of disease onset≤72 h) and subacute group (n=158, time of disease onset＞72 h). The mean time of operation, volumes of bleeding during operation, rates of transference to open abdominal surgery, scores of visual analogue scale (VAS) after operation, prevalences of complications after operation and duration of hospitalization were compared between LC group and OC group and between acute group and subacute group. Results Compared with OC group, the time of operation and duration of hospitalization were shorter, the volume of bleeding during operation was smaller and VAS was lower in LC group, and there were significant differences in these parameters between two groups (P<0.05). There was no significant difference in the prevalences of complications after operation between OC group and LC group (P>0.05). Compared with subacute group, the time of operation and duration of hospitalization were shorter, the volume of bleeding during operation was smaller and the rate of transference to open abdominal surgery was lower in acute group, and there were significant differences in these parameters between two groups (P<0.05). Conclusion LC is feasible and safe for patients with acute cholecystitis, and surgical intervention within 72 h of disease onset may yield higher success rate and safety.

Key words: acute cholecystitis, cholecystectomy, laparoscope, complication