Laparoscopic Cholecystectomy in Complicated Acute Cholecystitis : Risk Factors and Outcome

Introduction: Complicated acute cholecystitis (AC) due to gangrene, perforation, emphysema or empyema of gall bladder is associated with increased post operative morbidity and mortality rates. The aim of this study is to determine the risk factors and outcome of complicated AC.

Methods: A total of 50 patients of acute cholecystitis who underwent laparoscopic cholecystectomy were prospectively studied and the risk factors associated with the development of complicated AC were investigated. The outcome of laparoscopic cholecystectomy was compared between patients of complicated and uncomplicated AC. The data obtained was analysed.

Results: On multivariate analysis, old age, diabetes mellitus (DM), hypertension (HT), male sex and raised total leucocyte count (TLC) (13.81 ± 6.95) were predictive risk factors for complicated acute cholecystitis. Mean operative time and hospital stay was longer in complicated AC patients as compared with uncomplicated AC. There was no significant difference in conversion rates, post operative TLC, wound infection or bile duct injuries between the two. However, post operative fever was significantly present in patients of complicated AC.

Conclusion: Various preoperative risk factors for complicated acute cholecystitis are old age, DM, HT, raised TLC and male sex. Outcome of laparoscopic cholecystectomy in patients of complicated acute cholecystitis lead to increase in mean operative time and total length of hospital stay.