LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE GALL BLADDER

Objective: To look for the feasibility and results of laparoscopic cholecystectomy in acutely inflamed gall bladder, gangrenous cholecystitis and empyema gall bladder.Methodology: It was a prospective observational case series. As an institutional policy early laparoscopic cholecystectomy was performed in all the patients with diagnosis of acute cholecystitis. The incidence of gangrenous cholecystitis and empyema gall bladder was noted and laparoscopic intervention was preferred in all these patients. The demographic profile, clinical records, operative details, complications and follow up details were prospectively gathered on a performa.Results: Early laparoscopic cholecystectomy was performed in 142 patients. 103 patients had simple acute cholecystitis, 13 patients had empyema gall bladder and 26 patients had gangrenous cholecystitis. The incidence of comorbids such as diabetes mellitus, hypertension and ischemic heart diseases was 28.1%, 61.5 and 80.75 in patients with simple acute cholecystitis, empyema gall bladder and gangrenous cholecystitis respectively. Male gender was predominating in patients with complicated cholecystitis. The open conversion rate was 3.88% in simple acute cholecystitis, 15.38% in empyema gall bladder and gangrenous cholecystitis combined. There were 2 major complications in patients with simple acute cholecystitis and 2 major complications in patients with gangrenous cholecystitis. There was one mortality in a patient with simple acute cholecystitis.Conclusion: Laparoscopic cholecystectomy is a safe and effective option in acute gall bladder. Based on our experience we recommend an early laparoscopic gall bladder removal, provided expertise & gadgets are available.