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ORIGINAL ARTICLE
Year : 2018  |  Volume : 46  |  Issue : 4  |  Page : 288-291

Evaluation of laparoscopic cholecystectomy in treatment of acute cholecystitis


Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
MSc Mohamed Mousa
Department of General Surgery, Faculty of Medicine, Tanta University, El-Gharbia, Tanta, El-Nady Street from Ali Mubarak
Egypt
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DOI: 10.4103/tmj.tmj_52_17

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Background There is a controversy for laparoscopic cholecystectomy (LC) in acute cholecystitis with higher morbidity rates in an emergency procedure and the higher conversion rate to open procedure. The main reason is inflammation obscuring the view of Calot’s triangle view, whereas in late phase it is fibrotic adhesion, which will be associated with the bile duct injury. Aim This study was designed to evaluate the safety of LC for the treatment of acute cholecystitis. Patients and methods This prospective study included 30 patients who were treated by LC after 24 h. The timing of intervention was within 7 days from the beginning of the symptoms. Results All patients presented with elevated C reactive protein (CRP), which was higher in patients with high grade fever, who had palpable tender right hypochondrial mass and also in pyocele patients. Both CRP and total leukocyte count were noticed to be directly proportional to the amount of intraoperative hemorrhage. Males and pyocele patients had delayed time of intervention. Delayed timing of intervention was directly proportional to male and pyocele patients, intraoperative hemorrhage, and amount of drain postoperative. Total operative time was with mean 109.57 and blood loss was with mean 95. Longer operative time was associated with male sex, high-grade fever preoperatively, presence of palpable tender right hypochondrial mass, and higher total leukocyte count and CRP levels. Total hospital stay ranged from 4 to 6 days and increased with male sex and pyocele patients and delayed timing of intervention. Six patients had a postoperative superficial wound infection. Conclusion It was found that early LC allowed significantly shorter total hospital stay and early return to work and avoided repeated admissions for recurrent symptoms with no added morbidity or mortality.


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