caa a22 4500 477034578 CHVBK 20180405111301.0 cr unu---uuuuu 170330e19960101xx s 000 0 eng 10.1007/s002689900008 doi (NATIONALLICENCE)springer-10.1007/s002689900008 Laparoscopic Cholecystectomy for Acute Cholecystitis: Is It Really Safe? [Elektronische Daten] [Cheng-Kiong Kum, Ernst Eypasch, Rolf Lefering, Andreas Paul, Edmund Neugebauer, Hans Troidl] Abstract. The prospectively collected data from 530 cholecystectomies performed in a university clinic from October 1989 to March 1991 were analyzed after 1 to 3 years of follow-up. The aim of this study was to compare the results of laparoscopic cholecystectomy (LC) for acute cholecystitis with that for routine symptomatic gallbladders. The preoperative, intraoperative, and postoperative parameters of 424 routine (noninflamed) LCs and 54 LCs for acutely inflamed gallbladders were compared under the "intention to treat” principle. Operating time was longer in the inflamed group (median 97 minutes versus 75 minutes;: p < 0.0001). Significantly more adhesions (20% versus 8%), more blood loss (48% versus 19%), a higher incidence of bile spillage (28% versus 12%), and lost stones (19% versus 8%) were encountered in patients with acute cholecystitis. Common bile duct (CBD) injuries were also more frequent in that group (5.5% versus 0.2%; p = 0.005). The rate of conversion to open surgery was higher than with routine LCs (13% versus 4%). There were two deaths in the routine LC group and none in the acutely inflamed group. There was no difference in postoperative pain intensity or postoperative fatigue according to visual analog scale measurements. Patients with acute cholecystitis stayed only 1 day longer (median 4 days versus 3 days) in hospital. The quality of life scores indicate return to almost normal values by the 14th postoperative day. Long-term follow-up (1-3 years) did not reveal any delayed clinical adverse effects. In summary, LC for inflamed gallbladders has a higher conversion rate than LC for routine symptomatic gallbladders. If successfully performed, it has definite benefit for the patient in terms of better postoperative recovery. The trade-off is that the risk of CBD injury is significantly higher. 1996 by the Société Internationale de Chir, ugie Kum Cheng-Kiong Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut Eypasch Ernst Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut Lefering Rolf Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut Paul Andreas Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut Neugebauer Edmund Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut Troidl Hans Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut https://doi.org/10.1007/s002689900008 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900008 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kum Cheng-Kiong Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut NATIONALLICENCE 700 1- Eypasch Ernst Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut NATIONALLICENCE 700 1- Lefering Rolf Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut NATIONALLICENCE 700 1- Paul Andreas Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut NATIONALLICENCE 700 1- Neugebauer Edmund Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut NATIONALLICENCE 700 1- Troidl Hans Second Department of Surgery, University of Cologne, Merheim Surgical Clinic, Ostmerheimer Strasse 200, Cologne 51109, Germany, DE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer