WHAT IS THE BEST TIMING TO PERFORM LAPAROSCOPIC
CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS ? Cr. Lupascu
First Surgical Clinic, „St. Spiridon” Hospital Iasi,
Research Center for Laparoscopic and Classic Surgery,
University of Medicine and Pharmacy „Gr.T. Popa” Iasi Jurnalul de chirurgie 2005; 1 (1):21-23 Full text:Format
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Abstract:
Early laparoscopic cholecystectomy within 5 days of onset of symptoms
of acute cholecystitis has proved better to open cholecystectomy.
Feasability is already well established; the conversion rate to open
cholecystectomy and the post-operative morbidity are not higher than
with the delayed laparoscopy after the initial medical management.
Total hospital stay is, on the other hand, significantly shorter.
Only one study showed an increase in operative time with early surgery
(on average 15 minutes). Both preoperative or perioperative risk factors
for conversion to laparotomy were identified.
Prompt laparoscopic intervention avoids the complications which may
arise with initial medical management, such as failure of medical
management or biliary peritonitis. Early laparoscopic cholecistectomy
should be considered the “gold standard” for management
of acute cholecystitis.
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