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Abstract

Objectives: Laparoscopic Cholecystectomy (LC) is gaining traction to become a safe and effective surgical option for Acute Cholecystitis (AC). In our institution, the trend toward laparoscopic management of AC has only recently gained traction. The objective of this study is to describe the early experience of our institu tion utilizing LC. Methods: This descriptive study involved a retrospec tive analysis of early institutional cases of LC. Included were cases with both pre- and post-operative diagnoses of AC, as well as cases admitted for non-AC conditions but found to have incidental AC postoperatively. Cases were further categorized into severe (SAC) and non severe AC groups. Primary outcomes included in traoperative adverse events (IAE), mortality, and con version rates. Secondary outcomes included timing of surgery, mean operative time, postoperative visual ana logue scale (VAS) scores, and length of postoperative hospital stay. Results: Among 596 cases, 14.6% (87 cases) were op erated on for AC. Of these, 19.5% (17 cases) were for severe acute cholecystitis (SAC), the remaining (80.46%) were for non-SAC. Majority (65.5%) were females with a mean age of 42 years old. Over-all rate of intraoperative events was 11.5 % ranging from cyst ic artery bleed, bleeding from liver bed, and uninten tional GB perforation. There were no bile duct or bowel injuries. There were no mortalities in this series. Con version rate was 1.1% (n=1, from the non-SAC group) due to difficult anatomy. Majority (88.5%) were oper ated on within 72 hours from admission. Mean opera tive time was 108 minutes, mean post-op stay was 53 hours. Mean VAS score at 6 hours post-op was 3.23 with further decrease to 2.76 and 2.15 at 12 and 24 hours post-op. Conclusions: Our institution’s first three years of expe rience with LC for AC demonstrate that the procedure is both feasible and safe, with low IAE and conversion rates and no associated mortality. Additionally, LC pro vides the benefit of reduced postoperative pain.

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