Laparoscopic cholecystectomy has become the standard elective man
agement of cholelithiasis. Little Information exists, however, regarding
the appropriateness of this procedure in the setting of acute symptomatol
ogy. We reviewed our results with 26 patients with acute biliary symp
toms managed laparoscopicahy.
There were 18 females and 8 males with their ages ranging from 22 to
70 years with an average of 46 years. Laparoscopic cholecystectomy
was attempted in all patients, and was succesfui in 22 of 26 patients,
four procedures were converted to open cholecystectomy because of diffi
culty in dissection precluding laparoscopic cholecystectomy.
Patients requiring open cholecystectomy were older, more likely to be
febrile (mean temperature of 37.9+ 0.6 versus 37+0.7 C)and were more
likely to have a significant leukocytosis frneon white cell Count 12.8 5.2
xlO3 cells/mm3 versus 9.22.8xlO3 cells/mm3) than were those under
going succesjul laparoscopic cholecystectomy.
Laparaoscopic cholecystectomy can be performed safely in the majority
of patients presenting with acute biliary symptoms. Patients presenting
• with a triad of right upper quadrant pain, fever and elevated white cell
count who are especlaly males, elderly and morbidly obese are more like
ly to require covrersion to a standard cholecystectomy and should be in
formed accordingly. |
