Laparoscopic cholecystectomy - A safe and feasible procedure in patients with mild-moderate acute cholecystitis: A single center, prospective, observational study

Abstract

Background/Aim: Laparoscopic cholecystectomy (LC) is the gold standard modality for treating the gallstone disease. However, it is associated with perioperative complications. Moreover, some of the patients with acute cholecystitis (AC) require conversion to open cholecystectomy (OC). Thus, the aim of this study is to assess the safety and feasibility of LC in patients with AC. Methods: This was a single center, prospective, observational study performed, over a period of 18 months (March 2019 to August 2020), in Department of General Surgery of a tertiary care center located in Central India. 96 patients fulfilling Tokyo guidelines (2018 diagnostic criteria for AC) were included. The feasibility was assessed in terms of conversion to OC, while safety was assessed in terms of postoperative complications in the first 30 days. Results: During LC, none of the patients required conversion to OC due to difficulty in dissection or anatomy. On postoperative day 1, the mean VAS score for pain was 2.1 (0.56), meaning of low pain. Mean length of hospital stay was 2.34 (0.61) days, thereby inferring shorter hospital stay. Mortality was not observed. During the follow-up period, 2 patients developed epigastric port-site infection, while other 2 reported port-site bleeding. Moreover, 2 patients had intra-abdominal collection. All the complications were managed conservatively. Conclusion:The study confirms that LC is feasible and safe in patients with AC, among the age group studied. LC can be a method of choice for AC due to decreased conversion rate, short hospital stays, reduced morbidity, and swift transition to routine.