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. 2006 Jul-Sep;10(3):332-5.

Gallstones: best served hot

Tarun Singhal  1 , Santosh Balakrishnan, Starlene Grandy-Smith, John Hunt, Maxwell Asante, Shamsi El-Hasani
Affiliations

Gallstones: best served hot

Tarun Singhal et al. JSLS. 2006 Jul-Sep.

Abstract

Background: Acute episodes of gallstone-related diseases have traditionally been managed conservatively. In the event of gallstones obstructing the common bile duct, patients had endoscopic extraction of calculi with interval cholecystectomy after 4 weeks to 6 weeks when acute inflammatory changes have subsided. This placed the patient at risk of recurrent cholecystitis, pancreatitis, or other complications of cholelithiasis.

Methods: Patients presenting with acute gallstone-related diseases were investigated and underwent laparoscopic cholecystectomy during the same admission according to a predetermined treatment protocol.

Results: All patients (119) treated according to the study protocol had good results, with no 30-day mortality and no biliary tract injuries. One patient had bleeding from the cystic artery, and 6 patients required conversion to open cholecystectomy.

Conclusion: Growing expertise in laparoscopic cholecystectomy has made it possible for surgeons to perform safe cholecystectomy in the presence of acute gallstone-related disease. Our experience of managing gallstone disease with prompt cholecystectomy during the index admission shows that this approach provides better, safer, and more cost-effective patient care.

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