Laparoscopic management of acute cholecystitis: A single centre experience in Benghazi Libya

Abstract

Background: Laparoscopic cholecystectomy (LC) is often performed early for treatment of acute cholecystitis (AC), and has become the treatment of choice for this diagnosis. This has reduced length of stay and is cost effective. It may, however, carry a higher morbidity and an increased rate of conversion to open cholecystectomy. In this article we evaluated the role of early laparoscopic cholecystectomy in surgical treatment of acute cholecystitis at our center.Patients and methods: A retrospective analytical review of 114 cases of acute cholecystitis treated by laparoscopic cholecystectomy is presented. All cases were performed by the authors between 2002 to 2008. All patient records were reviewed and analyzed for age, sex, duration of symptoms, operative findings, conversion rate to open cholecystectomy, length of hospital stay, and any postoperative complications.Results: the mean age of patients was 34.5 years (range 25 to 80). Female to male ratio was 4:1. Operative interventions were performed within the first five days from onset of attack. Operative findings included acute inflammation of the gall bladder with superficial adhesions in 84 (74%) patients. An inflammatory mass with difficult adhesions was found in 20 (18%) patients. Empyema of gall bladder was noted in 10 (9%) cases. Mean length of stay was 2.5 days. Conversion to open cholecystectomy totaled nine (7%) cases. Two cases (1.7%) developed postoperative bile leaks, two (1.7%) cases had postoperative bleeding, 10 (8.7%) cases had postoperative chest infections and two (1.7%) cases had wound infection at the entry port of extracting the gall bladder. There was zero mortality.Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is feasible and safe and is today's treatment of choice for this event. The primary benefits are shorter hospital stay and quicker recovery.