Laparoscopy and Acute Cholecystitis: The Evidence

Abstract

The laparoscopic approach for acute cholecystitis has gained wide acceptance over the years. The indications for laparoscopic cholecystectomy in an acute setting are examined and the evidence provided by the literature reviewed. Today, the laparoscopic cholecystectomy can be considered the treatment of choice for acute cholecystitis. Severe (gangrenous, empyematous) cholecystitis and advanced age do not preclude the laparoscopic indication. Surgery should be done as soon as possible rather than delayed after the resolution of the acute phase. Percutaneous cholecystostomy cannot be recommended as part of a routine protocol for treatment of acute calculous cholecystitis. At present, no evidence-based classification allows us to tailor the treatment of every single patient according to the general or local conditions.