Role of laparoscopic cholecystectomy in the early management of acute gallbladder disease

Background: This study evaluated the role of laparoscopic surgery in the early management of acute gallbladder disease in a single large UK teaching hospital. Methods: Details of all emergency admissions for acute gallbladder disease from January 2000 to December 2001 were identified and additional...

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Bibliographic Details
Published in:British journal of surgery 2005-05, Vol.92 (5), p.586-591
Main Authors: Peng, W. K., Sheikh, Z., Nixon, S. J., Paterson-Brown, S.
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Biliary Tract Diseases - surgery
Biological and medical sciences
Cholecystectomy, Laparoscopic - methods
Cholecystitis, Acute - surgery
Cholelithiasis - surgery
Female
Gallbladder Diseases - surgery
General aspects
Humans
Male
Medical sciences
Middle Aged
Pain - etiology
Pain - surgery
Prospective Studies
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Summary:Background: This study evaluated the role of laparoscopic surgery in the early management of acute gallbladder disease in a single large UK teaching hospital. Methods: Details of all emergency admissions for acute gallbladder disease from January 2000 to December 2001 were identified and additional information from the hospital records was reviewed retrospectively. Results: Three hundred and eighty‐five patients with gallstone disease (243 acute biliary pain, 142 acute cholecystitis) and 15 with acalculous disease were identified. The conversion rate was higher during early laparoscopic surgery for acute calculous cholecystitis than in operations for acute biliary pain (19 versus 4 per cent; P = 0·002). In patients with acute calculous cholecystitis the conversion rate was significantly lower in operations within 48 h of admission (one of 26) than when surgery was delayed beyond 48 h (14 of 52) or subsequently carried out electively (seven of 21) (P = 0·014). Elective surgery for previous acute cholecystitis was associated with a higher conversion rate (seven of 21 patients) than elective surgery for biliary pain (three of 65) (P = 0·002). Conclusion: Laparoscopic cholecystectomy for acute calculous cholecystitis should be performed, where possible, within the first 48 h of admission. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Within first 48 hours of admission
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.4831