Safety and Feasibility of Laparoscopic Cholecystectomy in Acute Cholecystitis

Objective: To have an audit of the outcome of laparoscopic cholecystectomy for acute cholecystitis at a tertiary care centre. Study Design: An observational study. Place and Duration of Study: Department of Surgery, Prime Teaching Hospital, Peshawar Medical College, Peshawar, KPK, Pakistan, from January 2011 to December 2015. Methodology: Patients with acute cholecystitis undergoing laparoscopic cholecystectomy were evaluated for conversion rate, morbidity and hospital stay. Early laparoscopic cholecystectomy was defined as done within the same hospital admission. Results: In 83 patients, male to female ratio was 1: 1.6 with a median age of 46 years (IQR 15). The median interval between the onset of symptoms and time of surgery was 5 days (IQR 3). Majority of cases (80%) were performed after 72 hours of their presentation as acute cholecystitis. Conversion rate from laparoscopic to open cholecystectomy was 8.4% (7/83 cases), because of difficult dissection and unclear anatomy at the Calot's triangle. Median duration of hospital stay was 2 days (IQR 1). Morbidity rate was 9.6% (8/83 cases), all occurring in late presentations; port-site infection being the commonest (n= 6, 7%), followed by port-site hernia and post-cholecystectomy pancreatitis (n= 1 each). Conclusion: Laparoscopic cholecystectomy is quite safe in acute cholecystitis with a low conversion rate, bile duct injuries, and hospital stay.