Surgical Outcomes of Laparoscopic Cholecystectomy for Severe Acute Cholecystitis
The aim of this study was to evaluate surgical outcomes of Laparoscopic cholecystectomy (LC) in patients who were diagnosed with severe acute cholecystitis (SAC) and to clarify useful treatment modalities of SAC. Of 112 patients who presented SAC, we selected 99 paatients and divided them into three groups; 37 patients who underwent preoperative percutaneous transhepatic gallbladder drainage (PTGBD) (Group 1), 62 patients with SAC but not indicated for PTGBD (Group 2) and 59 patients with acute and chronic cholecystitis (Group 3). The conversion rate was 2.7% (1/37) in group 1, 6.5% (4/62) in group 2, and 1.7% (1/59) in group 3. In groups 1 and 2, the postoperative stay and operative time were longer than those in group 3 with significant difference, respectively (P<0.05). In group 2, there was correlation not only between postoperative stay and age but also between postoperative stay and ASA class (P<0.05). In group 2, there was nocorrelation between time to operation and operative time and also between time to operation and postoperative stay, however, there was surprisingly significant correlation between time to operation and conversion rate in SAC(P=0.018). In conclusion, PTGBD should selectively be performed in patients with severe comorbidities rather than improving surgical outcomes of LC for severe acute cholecystitis. If patients are not indicated for PTGBD, an early laparoscopic cholecystectomy is recommended because it can decrease conversion rate, although it can’t decrease operative time and postoperative stay.
Severe acute cholecystitis, Laparoscopic cholecystectomy, 담낭
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