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ROLE OF LAPAROSCOPIC CHOLECYSTECTOMY IN THE MANAGEMENT OF ACUTE CHOLECYSTITIS

Atta H. Soomro, Aijaz A. Memon, Khalid Ahsan Malik and Bhagwant Devi.

Abstract
OBJECTIVES: To evaluate the safe technique of surgery in patients with acute cholecystitis and
to highlight the better method in which patient can be prevented from complications.
DESIGN: A descriptive study.
SETTING: This study was conducted at Larkana, Sindh from February 2002 to August 2004.
METHODS: A total of 504 patients underwent laparoscopic cholecystectomy. Out of these, 398
patients were treated by elective laparoscopic cholecystectomy and 106 patients underwent
emergency laparoscopic cholecystectomy for acute cholecystectitis.
RESULTS: Among 106 patients, females were double (73.1%) than males and most of these
patients were received within 24 hours of the onset of symptoms. In 56 (52.83%) patients,
ultrasound revealed odematous gall bladder, mucocele, empyma, contracted, perforated and
gangrenous gall bladder. Per-operative complication was encountered in 71 (66.98%) patients
including bleeding, minor injury to common bile duct (CBD) and liver, adhesions of gall bladder
with omentum, stomach, colon, CBD, and distorted anatomy of Calotís triangle. The minimum
time taken during the procedure was 50 minutes. In 5 (4.72%) patients, the laparoscopic
procedure was converted to open and reasons for conversion were bleeding, tight, dense
adhesions and perforated gallbladder leading to biliary peritonitis.
CONCLUSION: Emergency cholecystectomy is reliable and safe modality in the management of
acute cholecystitis. Certain factors are responsible for the conversion, which include delayed
arrival of patient, patients with perforated gall bladder, bleeding and adhesions. Hence,
emergency laparoscopic cholecystectomy seems to be safe, cost effective, and timely surgery
with modern conception. This timely surgery prevents the complications associated with acute
cholecystitis.

Key words: Laparoscopy. Cholecystectomy. Emergency. Management. Complications.






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The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.