Outcome of Laparoscopic Cholecystectomy in Patients of Acute Cholecystitis

Abstract

Objective: To assess the outcome of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Study Design: Quasi experimental study. Place and Duration of Study: The study was conducted at Surgical Unit I, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from 1 Jan 2013 to 31 Dec 2018. Materials and Methods: All those patients who reported within 72 hours of onset of symptoms of acute calculus cholecystitis were included. Patients of acute pancreatitis, choledocholithiasis, with comorbids and previous abdominal surgery were excluded. Three port LC was performed in patients of acute cholecystitis after diagnosis by consultant skilled surgeon. Data were collected in a proforma that included demographics of the patient, operative findings, operating time, intra- or post-operative complications and duration of hospital stay. Data was collected and SPSS version 20 was used for analysis. Results: Total 143 patients of acute calculous cholecystitis were studied with 38 males and 105 females. The mean age of patients was 46.23 years ranged from 22 to 76 years. The mean operative time was 68.1 ± 25.31 minutes with conversion rate of 2.1%. The overall rate of complication was 24.5 per cent and no serious bile duct injury was noted in any patient. Bleeding (5.6%) and biliary injury (2.1%) were intraoperativer complications. Port site infection (6.3%), chest infection (3.5%) and biliary leak (2.8%) were major postoperative complications. The mean total hospital stay was 4.16 (3–8 days). Conclusion: Laparoscopic Cholecystectomy can be performed safely in patients with acute calculous cholecystitis within 72 hours of the onset of symptoms.

Keywords

• acute cholecystitis, biliary injury, cholelithiasis, laparoscopic cholecystectomy, post site infection.