Primary laparoscopic cholecystectomy for acute cholecystitis

The role of laparoscopic cholecystectomy on patients with histologically confirmed acute cholecystitis is still controversial. From January 1992 to December 1996, 228 cholecystectomies were performed for acute cholecystitis and a total of 104 patients were operated on conventionally and 124 patients underwent laparoscopic surgery. In a prospective study we compared the conventional with the laparoscopic technique. The results indicated that in 19 patients (15.3 %) treated initially with the laparoscopic technique, a switch to laparotomy was required. The operating duration was lower for conventional cholecystectomy (75 min versus 95 min). However, surgical and nonsurgical complication rates were similar in both groups. The period of hospitalization was shorter in laparoscopic operations. According to these results we believe that laparoscopic cholecystectomy in patients with acute cholecystitis is a safe and effective procedure. The patients will benefit from the advantages of laparoscopic surgery without increased morbidity.