caa a22 4500 475780744 CHVBK 20180406123643.0 cr unu---uuuuu 170329e20000401xx s 000 0 eng 10.1007/s004640020088 doi (NATIONALLICENCE)springer-10.1007/s004640020088 Laparoscopic cholecystectomy in acute cholecystitis [Elektronische Daten] A prospective comparative study in patients with acute vs chronic cholecystitis [P. Pessaux, J. J. Tuech, C. Rouge, R. Duplessis, C. Cervi, J. P. Arnaud] Background: The aim of this prospective study was to compare the outcome of laparoscopic cholecystectomy (LC) in patients with acute cholecystitis versus those with chronic cholecystitis and to determine the optimal timing for LC in patients with acute cholecystitis. Methods: From January 1991 to July 1998, 796 patients (542 women and 254 men) underwent LC. In 132 patients (67 women and 65 men), acute cholecystitis was confirmed via histopathological examination. These patients were divided into two groups. Group 1 (n= 85) had an LC prior to 3 days after the onset of the symptoms of acute cholecystitis, and group 2 (n= 47) had an LC after 3 days. Results: There were no mortalities. The conversion rates were 38.6% in acute cholecystitis and 9.6% in chronic cholecystitis (p < 10−8). Length of surgery (150.3 min vs 107.8 min; p < 10−9), postoperative morbidity (15% vs 6.6%; p= 0.001), and postoperative length of stay (7.9 days vs 5 days; p < 10−9) were significantly different between LC for acute cholecystitis and elective LC. For acute cholecystitis, we found a statistical difference between the successful group and the conversion group in terms of length of surgery and postoperative stay. The conversion rates in patients operated on before and after 3 days following the onset of symptoms were 27% and 59.5%, respectively (p= 0.0002). There was no statistical difference between early and delayed surgery in terms of operative time and postoperative complications. However, total hospital stay was significantly shorter for group 1. Conclusions: LC for acute cholecystitis is a safe procedure with a shorter postoperative stay, lower morbidity, and less mortality than open surgery. LC should be carried out as soon as the diagnosis of acute cholecystitis is established and preferably before 3 days following the onset of symptoms. Early laparoscopic cholecystectomy can reduce both the conversion rate and the total hospital stay as medical and economic benefits. Springer-Verlag New York Inc., 2000 Key words: Acute cholecystitis — Gallbladder — Laparoscopic cholecystectomy — Optimal timing nationallicence Pessaux P. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut Tuech J. J. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut Rouge C. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut Duplessis R. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut Cervi C. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut Arnaud J. P. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 358-361 0930-2794 14:4<358 2000 14 464 https://doi.org/10.1007/s004640020088 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640020088 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pessaux P. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut NATIONALLICENCE 700 1- Tuech J. J. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut NATIONALLICENCE 700 1- Rouge C. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut NATIONALLICENCE 700 1- Duplessis R. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut NATIONALLICENCE 700 1- Cervi C. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut NATIONALLICENCE 700 1- Arnaud J. P. Department of Visceral Surgery, 4 rue Larrey, Angers 49100, France, FR aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 358-361 0930-2794 14:4<358 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer