Early Laparoscopic Cholecystectomy with Continuous Pressurized Irrigation and Dissection in Acute Cholecystitis

Abstract

Background. The aim of this study was to evaluate the preliminary results of a new dissection technique in acute cholecystitis. Material and Method. One hundred and forty-nine consecutive patients with acute cholecystitis were operated on with continuous pressurized irrigation and dissection technique. The diagnosis of acute cholecystitis was based on clinical, laboratory, and radiological evidences. Age, gender, time from symptom onset to hospital admission, operative risk according to the American Society of Anesthesiologists (ASA) score, white blood cell count, C-reactive protein test levels, positive findings of radiologic evaluation of the patients, operation time, perioperative complications, mortality, and conversion to open surgery were prospectively recorded. Results. Of the 149 patients, 87 (58,4%) were female and 62 (41,6%) were male. The mean age was 46.3 ± 6.7 years. The median time from symptom onset to hospital admission 3.2 days (range, 1–6). There were no major complications such as bile leak, common bile duct injury or bleeding. Subhepatic liquid collection occurred in 3 of the patients which was managed by percutaneous drainage. Conversion to open surgery was required in four (2,69%) patients. There was no mortality in the study group. Conclusion. Laparoscopic cholecystectomy with continuous pressurized irrigation and dissection technique in acute cholecystitis seems to be an effective and reliable procedure with low complication and conversion rates.

Incidence and predictors of common bile duct stones in patients with acute cholecystitis: a systematic literature review and meta‐analysis

“…S1). The remaining 19 studies with a total of 4057 patients with AC were included in this systematic review (Fig. ).…”

“…The criteria used for the diagnosis of AC were reported by 15 studies. AC was diagnosed by histology in five studies, whereas eight studies used clinical diagnosis . Two studies employed a combination of histology and clinical diagnosis .…”

“…A total of 715 studies were identified by the initial search. After applying the inclusion and exclusion criteria, 693 studies were excluded, leaving 22 studies to be included in our analysis (Fig. ).…”

“…The characteristics of the studies identified are shown in Table . Six studies were conducted in Asian countries, 12 were conducted in Europe or the USA and one was conducted in Israel . The overall incidence of CBDS in patients with AC was estimated as 13.7% (95% confidence interval (CI) 11.8–15.9) (Fig.…”

Experiencia en el manejo quirúrgico de la colelitiasis en el Servicio de Cirugía I del Complejo Hospitalario Universitario Ruiz y Páez

“…Existen informes que indican que la estancia hospitalaria es más prolongada para la colecistectomía temprana. [26][27][28][29] Únicamente cerca de 30% de las colecistectomías laparoscópicas en Estados Unidos se realizan durante la colecistitis aguda. Sólo 20% de los cirujanos del Reino Unido realizan la colecistectomía laparoscópica durante la colecistitis aguda.…”