Vinay Boppasamudra Nanjegowda1, Savitha Krishnagouda Karlwad2, Venugopal Hunasanahalli Girryappa3, Nagesh Nayakarahalli Swamygowda4, Ashok Kumar Kopparum Vishwanath5
BACKGROUND
Gangrenous cholecystitis is considered the most severe form of acute cholecystitis. It is associated with high morbidity and sometimes mortality. In the past studies laparoscopic cholecystectomy was considered an option for treatment of gangrenous cholecystitis with high conversion rates. This study investigates the feasibility of laparoscopic cholecystectomy in gangrenous cholecystitis and also factors predicting gangrenous disease in symptomatic cholelithiasis.
MATERIALS AND METHODS
We reviewed our experience in patients undergoing cholecystectomies between 2013 to 2016. In this period, 350 cholecystectomies were performed of which 37 had gangrenous cholecystitis. Acute gangrenous cholecystitis was diagnosed based on gross and microscopic appearance of gall bladder. Data analysis was done using simple statistical tools.
RESULTS
Out of 350 patients who underwent cholecystectomy during the study period, gangrenous gallbladder was found in 37 (10.7%) patients. 29 patients underwent laparoscopic cholecystectomy, 5 (13.5%) patients with gallbladder gangrene underwent open cholecystectomy and 3 (8%) patients were converted to open from lap. Risk factors for gallbladder gangrene included male gender, age older than 50 years, history of cardiovascular disease and diabetes, and leukocytosis greater than 17,000 white blood cells/ml.
CONCLUSION
Laparoscopic cholecystectomy is safer in gangrenous cholecystitis with less conversion rate leading to faster recovery and decreased length of hospital stay.
