Laparoscopic Cholecystectomy in Management of ACC Within and After 3 Days
Laparoscopic Cholecystectomy in Management of ACC Within and After 3 Days
This study was aimed to assess the outcome of laparoscopic cholecystectomy in acute calculous
 cholecystitis in terms of conversion rates, postoperative complications and length of
 hospital stay within and after 3 days of symptoms onset.
Acute cholecystitis is an inflammatory process presenting with biliary colic that is
 unremitting and may persist for more than 1 day. Obstruction of the cystic duct by a
 gallstone is the initiating event that leads to distention, inflammation and edema of the
 gallbladder wall. When the gallbladder remains obstructed and secondary bacterial infection
 supervenes, an acute gangrenous cholecystitis develops and an abscess or empyema forms within
 the gallbladder. The perforation usually is contained in the sub-hepatic space by the
 omentum.

 Early cholecystectomy performed within 2 to 3 days of presentation is preferred over interval
 or delayed cholecystectomy that is performed 6 to 10 weeks after initial medical therapy.
 About 20% of patients fail initial medical therapy and require surgery during the initial
 admission or before the end of the planned conservative period. Since last 20 years,
 increasing number of surgeons have favored a policy of early surgery. Several randomized
 studies have shown that performing early cholecystectomy for acute cholecystitis is better
 than delayed cholecystectomy in terms of shorter hospital stay, better operative outcome.
 Though recovery from disease is earlier in early cholecystectomy group, both groups have
 similar operative morbidity and mortality rates. This study aims to evaluate the surgical
 outcomes of laparoscopic cholecystectomy for ACC within and after 3 days of symptoms onset.
Inclusion Criteria:

 1. Abdominal pain characteristic of Acute Cholecystitis, Positive Murphy's sign, Total
 Leucocyte Count > 10,000/ uL, and (4) Ultra-sonographic evidence of Acute Calculous
 Cholecystitis.

 2. Initial surgical management planned for immediate laparoscopic cholecystectomy.

 3. Patients who are fit for laparoscopy and general anesthesia.

 4. Patient who agree to provide short term outcome data and agree to provide contact
 information.

 Exclusion Criteria:

 1. Patients with ultra-sonographic findings of common bile duct calculi, pancreatitis,
 gall bladder perforation, gall bladder gangrene or gall bladder abscess.

 2. Patients with other associated abdominal pathology.

 3. Patients with any previous abdominal surgery or any significant systemic disease.

 4. Septic shock.

 5. Pregnancy/ Breast-feeding mothers.