Chirurgia italiana
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The aim of the study was to demonstrate the importance of early laparoscopic cholecystectomy for acute cholecystitis, without "conservative" treatment (intravenous fluids and antibiotics for 48-72 hours) to reduce inflammation. Early laparoscopic cholecystectomy reduces bile duct injury and the percentage of conversion to open cholecystectomy. Thirty-five patients with acute cholecystitis were submitted to early laparoscopic cholecystectomy, equally divided according to sex. ⋯ One patient presented jaundice on day 30 after laparoscopy owing to inadequate positioning of the clips on the cystic duct, near the common bile duct; ERCP was performed with application of a prosthesis, which was removed after two months. Our experience and results support the validity of early laparoscopic cholecystectomy in the treatment of acute cholecystitis, because it reduces the postoperative length of hospital stay and hospital costs. Early treatment is always helpful for inflamed and oedematous tissue which favours dissection, while dense, fibrotic adhesions hinder regular dissection with a greater risk of injury to the biliary duct and and a higher conversion rate to open cholecystectomy.