Is laparoscopic cholecystectomy applicable to patients with acute cholecystitis?

Laparoscopic cholecystectomy will become the standard surgical treatment for gallbladder disease only if the methodology is applicable to all or near all cases. To evaluate this hypothesis, all patients were operated on via the laparoscopic route, regardless of whether or not they had signs of acute infection. Among a total group of 411 patients operated upon laparoscopically, 193 (47%) had clinical or anatomical signs of acute infection. The surgery was somewhat protracted and the hospital stay longer, but no major complication occurred. It can then be concluded that in skilled hands, laparoscopy is a safe route for cholecystectomy in the presence of acute infection and inflammation, and that it offers the benefits of minimally invasive surgery to those patients.