Experience in laparoscopic cholecystectomy in treatment of acute calculous cholecystitis: a clinical analysis of 86 cases

Objective To investigate the clinical effect of laparoscopic cholecystectomy ( LC) in the treatment of acute calculous cholecystitis. Methods A retrospective analysis was performed for the clinical data of 86 patients with acute calculous cholecystitis who underwent LC in Department of General Surgery in Nanjing Jiangning Hospital Affiliated to Nanjing Medical University from May 2016 to May 2017. Results The surgery was performed within 1 week after disease onset, with a time of operation of 60-130 minutes ( mean 75. 5 ± 10. 5 minutes) , an intraoperative blood loss of 40-200 ml ( mean 70 ± 11. 2 ml) , and a length of postoperative hospital stay of 3-14 days ( mean6 ± 1. 5 days) . Of all 86 patients, 40 had simple acute cholecystitis, 38 had acute pyogenic cholecystitis, 5 had acute gangrenous cholecystitis, and 3 had an acute exacerbation of chronic cholecystitis; 6 patients were converted to open surgery, and 80 underwent a successful surgery, among whom one underwent primary duodenal repair due to cholecystoduodenal fistula. Intraoperative cholangiography was performed for 20 patients, among whom one was found to have common bile duct stones, and then common bile duct exploration and T-tube drainage were performed; two patients were found to have bile duct injury, which was repaired during surgery, and T-tube drainage was performed for one patient and primary suture was performed for the other patient. One patient experienced bile leakage after surgery and was cured after conservative treatment; all the other patients had no complications such as bile leakage and bleeding. Conclusion For acute calculous cholecystitis, indications should be strictly followed and laparoscopy should be adequately mastered. LC is safe and effective with little trauma.