Laparascopic Cholecystectomy Outcome in Acute and Chronic Cholecystitis

Although Laparoscopic Cholecystectomy (LC) is one of the most common elective surgeries, its indication in acute cholecystitis is controversial. This retrospective study is comprised of 182 patients with acute or chronic cholecystitis admitted at Ekbatan and Tamin Ejtamaiee hospitals and underwent laparoscopic cholecystectomy from March 2002 to September 2006. Patients were divided into two groups: 1- patients with acute cholecystitis and 2- patients with chronic cholecystitis on the basis of surgical and pathological findings. Patients were compared for laparoscopic cholecystectomy results, complications, duration of hospital stay, and factors associated with conversion from laparoscopic cholecystectomy to open cholecystectomy. From 182 patients underwent LC, 39(21.4%) were male and 143 (78.6%) were female. The mean age of patients was 49±15.9 years (17-85 year). The mean age of patients with acute cholecystitis who underwent LC was significantly lower than those with chronic cholecystitis (p<0.05). The conversion rates was significantly higher in the acute cholecystitis group (p<0.05). Adhesion was the main reason for conversion to open surgery which was found in 16 (72.7%) patients. The conversion rate was 13.6% for adhesion plus hydrops, 9% for edema and 4.5% for pancereatic head cancer. This study showed that LC is an appropriate safe method for treatment of cholecystitis and can be served as the method of choice and first line therapy for cholecystitis.