IS LAPAROSCOPIC CHOLECYSTECTOMY EFFECTIVE AND RELIABLE IN THE CASE OFACUTE CHOLECYSTITIS - RESULTS OF A PROSPECTIVE-STUDY OF 221 HISTOLOGICALLY DOCUMENTED CASES

From December 1989 to May 1995, a prospective study of laparoscopic ch olecystectomy was carried out in our department, in order to assess th e reliability and safety of this method in the case of acute cholecyst itis. During this period, 1453 patients underwent laparoscopic cholecy stectomy. Acute cholecystitis was diagnosed in 280 patients, based on clinical history and macroscopic lesions. Only 221 cases (15 %) were i ncluded in the study after positive histology was obtained (M : 86, F: 135). The mean age was 62 years (20-90). Sixty-two patients (28 %) we re classified as ASA III and IV. The mean interval between the first s ymptoms and the operation was 9.9 days (1-53). The mean operating time was 130 minutes (45-420). Conversion to an open procedure was necessa ry in 22 cases (10%). The operative mortality was 0.9% (2 ASA IV patie nts) and the overall morbidity was 13.5 %. A bile duct injury occurred in 0.4 % of cases (1/221). In conclusion, laparoscopic cholecystectom y for acute cholecystitis is a safe procedure, when performed by opera tors experienced in laparoscopic surgery.