LAPAROSCOPIC CHOLECYSTECTOMY AS THE TREAT MENT OF CHOICE FOR ACUTE CHOLECYSTITIS - A PROSPECTIVE-STUDY

Between November 1989 and May 1994 103 laparoscopic cholecystectomies were performed for acute cholecystitis. Conversionrate was 4.9 %. Mort ality was 0. Postoperative morbidity was 10.7 % (6.8 % local complicat ions, 3.9 % systemic complications). None of the complications lead to a reoperation, no injuries of the common bile duct occurred. These re sults compare favorably to randomized studies of open cholecystectomy and to published result of laparoscopic cholecystectomy for acute chol ecystitis. Main determining factor for technical difficulty of the ope ration was the lapse of time between onset of symptoms and operation. This is expressed in statistically different mean operative times in p atients with short (1-6 days) and long (7-14; 15-21 days) clinical his tory of acute cholecystitis. We therefore conclude that early surgery, in selected cases even emergency surgery is indicated and that in exp ert hands laparoscopic cholecystectomy can be the treatment of choice for acute cholecystitis.