Purpose: The laparoscopic cholecystectomy(LC) has been accepted as the procedure of choice for cholecystitis although there are some limitations for patients who have severe cardiovascular and pulmonary dysfunction. But for acute suppurative cholecystitis, the safety and efficacy of LC has not been fully determined. Thus we designed this study to assess the clinical outcomes of LC for acute suppurative cholecystitis to evaluate its efficacy, safety and advantages over open cholecystectomy(OC).

Methods: We retrospectively analyzed 103 consecutive patients who met criteria of acute suppurative cholecystitis or empyema of their gallbladder by gross examination intraoperatively and/or postoperative histopathologic examination during the period from February 1996 to April 2001. During the early phase of this period, the rate of OC was higher, but later more patient were allocated to the LC by experienced surgeons. We compared the clinical outcomes such as mean hospital stay, duration of surgery, and complication rate between LC and OC group. The patients who were converted to OC were grouped to OC for analysis of clinical outcomes.

Results: LC was successful in 36 out of 56 patients and OC was done in 47 patients. Twenty(35.7%) patients in the LC group required conversion to OC. The LC and OC group were similar in demographic, physical and clinical characteristics. The mean duration of surgery was 102.0 minutes in LC and 132.6 minutes in OC group(p<0.05) and postoperative hospital stay was 7.7 versus 13.5 days in LC and OC respectively (p<0.05). The complication rate was 16.7%(6/36) in LC and 20.9%(14/67) in OC(p>0.05).

Conclusion: LC is feasible for most of the patients who have acute suppurative cholecystitis with acceptable complications and less duration of surgery and less hospital stay in comparison with OC for the patients who have similar clinical characteristics.

Keywords: Laparoscopic cholecystectomy, Acute suppurative cholecystitis