Acute cholecystitis: timing of laparoscopic cholecystectomy

Laparoscopic cholecystectomy is no more an elective procedure. The question is when to perform laparoscopic cholecystectomy in the face of acute cholecystitis. The last three years 57 patients had a laparoscopic cholecystctomy for acute cholecystitis. Twenty-one of them were operated on 24-48 h after the onset of the symptoms (group I), Fourteen of them in less than 4 weeks time after the attack of the acute cholecystitis (group II), while the rest twenty-two had a history of acute cholecystitis at least four weeks before their elective laparoscopic cholecystectomy (group III). Analysis of the operative time, complications and hospital stay showed that laparoscopic cholecystectomy in acute cholecystitis is nor a contraindication. The success of the operation depend on the degree of the inflammatory changes in the gallbladder and the expertise of the operator both in emergency and laparoscopic surgery. Timing of the operation is crusial to executing a successfull procedure. The operation is easier, faster and safer when perfomed in the first 24-48 h of the onset of the symptoms.