{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:28:58Z","timestamp":1767677338609,"version":"3.48.0"},"reference-count":12,"publisher":"BMJ","issue":"6850","license":[{"start":{"date-parts":[[1992,8,15]],"date-time":"1992-08-15T00:00:00Z","timestamp":713836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1992,8,15]]},"abstract":"<jats:p>OBJECTIVE--To evaluate the feasibility and safety of laparoscopic cholecystectomy in severe acute cholecystitis. DESIGN--Analysis of data collected prospectively from a consecutive series of 350 laparoscopic operations. SETTING--Two general surgical units in a teaching hospital. SUBJECTS--31 patients with a diagnosis of severe acute cholecystitis based on clinical examination, investigation results, and operative findings. INTERVENTIONS--Initial intravenous fluids and broad spectrum antibiotics followed by laparoscopic cholecystectomy within 72 hours of presentation. MAIN OUTCOME MEASURES--Failure to complete the operation laparoscopically, length of postoperative stay in hospital, early postoperative morbidity, interval from operation to full activity, and return to work. RESULTS--Laparoscopic cholecystectomy was attempted in 19 patients with empyema of the gall bladder and 12 who had severe cholecystitis which failed to settle on medical management. A total of 29 operations were successfully completed with two conversions to open surgery. Two minor postoperative complications occurred, and one case of retained common bile duct stones with jaundice was treated by endoscopic retrograde cholangiopancreatography and papillotomy. Median postoperative hospital stay was two days, with return to normal activity in seven days and to work in two weeks. There were no deaths related to the operation. CONCLUSIONS--In the presence of severe acute cholecystitis laparoscopic cholecystectomy is feasible in most patients, with minimal risk of injury to surrounding structures and considerable benefits. It is recommended that laparoscopic cholecystectomy should be attempted in these patients when appropriate surgical skill is available.<\/jats:p>","DOI":"10.1136\/bmj.305.6850.394","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T08:16:37Z","timestamp":1238400997000},"page":"394-396","source":"Crossref","is-referenced-by-count":83,"title":["Laparoscopic cholecystectomy as a safe and effective treatment for severe acute cholecystitis."],"prefix":"10.1136","volume":"305","author":[{"given":"R. G.","family":"Wilson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. M.","family":"Macintyre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. J.","family":"Nixon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. H.","family":"Saunders","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. S.","family":"Varma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. M.","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1992,8,15]]},"reference":[{"key":"ref_1","first-page":"385","article-title":"The European experience with laparoscopic cholecystectomy","volume-title":"Am7 Surg","volume":"161","author":"Cuschieri, A.; Dubois, F.; Mouiel, J.","year":"1991","unstructured":"Cuschieri A, Dubois F, Mouiel J, et al. The European experience with laparoscopic cholecystectomy. Am7 Surg 1991;161:385-7."},{"key":"ref_2","first-page":"60","article-title":"Coelioscopic cholecystectomy","volume":"211","author":"Dubois, F.; Icard, P.; Berthelot, G.; Levard, H.","year":"1990","unstructured":"Dubois F, Icard P, Berthelot G, Levard H. Coelioscopic cholecystectomy. Ann Surg 1990;211:60-3."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1089\/lps.1990.1.37","article-title":"Laparoscopic cholecystectomy for severe acute embedded and gangrenous cholecystitis","volume":"1","author":"Cooperman, A.M.","year":"1990","unstructured":"Cooperman AM. Laparoscopic cholecystectomy for severe acute embedded and gangrenous cholecystitis.J Lap Surg 1990;1:37-40.","journal-title":"J Lap Surg"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/0002-9610(91)90604-C","article-title":"The Baltimore experience with laparoscopic management of acute cholecystitis","volume":"161","author":"Flowers, J.L.; Bailey, R.W.; Scovill, W.A.; Zucker, K.A.","year":"1991","unstructured":"Flowers JL, Bailey RW, Scovill WA, Zucker KA. The Baltimore experience with laparoscopic management of acute cholecystitis. Am j Surg 1991;161: 388-92.","journal-title":"Am j Surg"},{"key":"ref_5","first-page":"14","article-title":"Laparoscopic treatment of acute cholecystitis","volume":"1","author":"Unger, S.W.; Edelman, D.S.; Scott, J.S.; Unger, H.M.","year":"1991","unstructured":"Unger SW, Edelman DS, Scott JS, Unger HM. Laparoscopic treatment of acute cholecystitis. SurgicalLaparoscopy and Endoscopy 1991;1: 14-6.","journal-title":"SurgicalLaparoscopy and Endoscopy"},{"key":"ref_6","first-page":"1333","article-title":"Laparoscopic laser cholecystectomy. Surg Eridosc","volume":"3","author":"Reddick, E.J.; Olsen, D.O.","year":"1989","unstructured":"Reddick EJ, Olsen DO. Laparoscopic laser cholecystectomy. Surg Eridosc 1989;3: 1333."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/0140-6736(91)90678-I","article-title":"Laparoscopic cholecystectomy","volume":"338","author":"Holohan, T.V.","year":"1991","unstructured":"Holohan TV. Laparoscopic cholecystectomy. Lancet 1991;338:801-3.","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/0140-6736(91)90674-E","article-title":"Elective laparoscopic cholecystectomy for \"all-comers\"","volume":"338","author":"Wilson, P.; Leese, T.; Morgan, W.P.; Kelly, J.F.; Brigg, J.K.","year":"1991","unstructured":"Wilson P, Leese T, Morgan WP, Kelly JF, Brigg JK. Elective laparoscopic cholecystectomy for \"all-comers\". Lancet 1991;338:795-7.","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1002\/bjs.1800621025","article-title":"Controlled clinical trial comparing early with interval cholecystectomy for acute cholecystitis","volume":"62","author":"McArthur, P.; Cuschieri, A.; Sells, R.A.; Sheilds, R.","year":"1975","unstructured":"McArthur P, Cuschieri A, Sells RA, Sheilds R. Controlled clinical trial comparing early with interval cholecystectomy for acute cholecystitis. Brj Surg 1975;62:850-2.","journal-title":"Brj Surg"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/0002-9610(91)90358-K","article-title":"Laparoscopic guided cholecystectomy","volume":"161","author":"Zucker, K.A.; Bailey, R.W.; Gadacz, T.R.; Imbembo, A.L.","year":"1991","unstructured":"Zucker KA, Bailey RW, Gadacz TR, Imbembo AL. Laparoscopic guided cholecystectomy. Am3J Sur 1991;161:36-44.","journal-title":"Am3J Sur"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1056\/NEJM199104183241601","article-title":"A prospective analysis of 1518 laparoscopic cholecystectomies","volume":"324","author":"Meyers, W.C.; Branum, G.D.; Farouk, M.","year":"1991","unstructured":"Meyers WC, Branum GD, Farouk M, et al. A prospective analysis of 1518 laparoscopic cholecystectomies. N EnglJ Med 1991;324:1073-8.","journal-title":"N EnglJ Med"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/BF01658790","article-title":"Changing trends in surgery for acute cholecystitis","volume":"14","author":"Reiss, R.; Nudelman, I.; Gutman, C.; Deutsch, A.","year":"1990","unstructured":"Reiss R, Nudelman I, Gutman C, Deutsch A. Changing trends in surgery for acute cholecystitis. 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