Laparoscopic cholecystectomy is largely preferred for all of the following reasons to conventional laparotomy except (AIIMS Nov 2010)
|B||Decreased incidence of bile duct injuries|
|D||Decreased stay in hospital|
a. Cholecystectomy is the definitive treatment for patients with acute cholecystitis.
b. Early cholecystectomy performed within 2 to 3 days of presentation is preferred over interval or delayed cholecystectomy that is performed 6 to 10 weeks after initial medical therapy.
c. About 20% of patients fail initial medical therapy and require surgery during the initial admission or before the end of the planned cooling-off period.
d. Laparoscopic cholecystectomy is the preferred approach to patients with acute cholecystitis.
e. Conversion to an open procedure should be made if the inflammation prevents adequate visualization of important structures.
f. The conversion rate to an open cholecystectomy is higher (4%-35%) in the setting of acute cholecystitis than with chronic cholecystitis.
g. Early laparoscopic cholecystectomy, due to a reduced length of hospital stay and readmissions, is a more cost-effective approach than open cholecystectomy for acute cholecystitis.
h. Patients who are operated on early in the course of their illness (within 48 hours) are more likely to have their procedure completed laparoscopically (4% versus 23%) than patients with a longer duration of symptoms.
i. Additional factors predicting the need to convert to an open cholecystectomy include increased patient age, male gender, elevated American Society of Anesthesiologists class, obesity, and thickened gallbladder wall (>4 mm).