La colecistite acuta: il timing operativo con l’approccio laparoscopico


Angela Pezzolla, Serafina Lattarulo, Gianluca Borrello, Ippazio Ugenti, Gennaro Fabiano, Nicola Palasciano

Ann. Ital. Chir., 2007; 78: 475-480

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The aim of this study is to evaluate the results of early cholecystectomy in patients with acute cholecystitis.
In the past, acute cholecystitis was a controindication to laparoscopic cholecystectomy because of the greater risk of injury
to the biliary duct, but acute gallbladder inflammation was a contraindication to open cholecystectomy, too.
With greater experience and new technology, laparoscopic cholecystectomy is today the gold standard in the treatment of
acute cholecystitis, in empyema and gangrenous cholecystitis.
In last years, attention move into surgical timing, rather than surgical management – open versus laparoscopy – because
there is no advantage in delaying cholecystectomy for acute cholecystitis.
In our experience, we always choose laparoscopic technique in all the patients without general controindications to miniinvasive
surgery and operate as soon as possible in patient under favourable conditions.
We believe that the patient early must be quickly stabilized with medical preoperative procedures and surgical treatment
must be performed within 72-96 hours after the onset of symptoms.
In the space of this hours, laparoscopic approach allows a reduction of operative time, operative risk and the conversion
rate with medical and economic advantages.