LAPAROSCOPIC CHOLECYSTECTOMY VS OPEN CHOLECYSTECTOMY IN THE TREATMENTOF ACUTE CHOLECYSTITIS - A PROSPECTIVE-STUDY

Objective: To compare the results of laparoscopic cholecystectomy (LC) with those of open cholecystectomy (OC) in the treatment of acute cho lecystitis. Design: A prospective, nonrandomized trial. Setting: ''Vir gen de la Arrixaca'' University Hospital, El Palmar (Murcia), Spain. P atients: One hundred fourteen patients underwent LC, and 110 underwent OC. The patients underwent surgery within 72 hours of the onset of sy mptoms. The patients were selected for LC or OC depending on the surge on's experience in laparoscopic surgery. Main Outcome Measures: Operat ing time, rate of conversion from LC to OC, complications, and length of hospital stay. Results: Conversion from LC to OC was necessary in 1 5 % of the patients. The mean operating time was 77 minutes for the OC group and 88 minutes for the LC group (P < .001). Complications occur red in 14 % of the patients in the LC group and in 23 % of the patient s in the OC group, with no significant differences between the 2 group s (P = .06). The number of moderate or severe complications was simila r in both groups, whereas mild complications were more common in the O C group (P < .02). The length. of the hospital stay averaged 8.1 days for the OC group and 3.3 days for the LC group (P < .001). Conclusions : Laparoscopic cholecystectomy is a safe, valid alternative to OC in p atients with acute cholecystitis. The technique has a low rate of comp lications, implies a shorter hospital stay, and offers the patient a m ore comfortable postoperative period than OC.