Laparoscopic management of acute and chronic cholecystitis.

Contrary to earlier predictions, it appears that acute cholecystitis should be considered a relative rather than an absolute contraindication to laparoscopic surgery. The most important parameter in determining the feasibility of attempting laparoscopic cholecystectomy in the setting of acute inflammation appears to be the experience of the surgeon. This also appears to be true when encountering individuals with elements of long-standing chronic cholecystitis. Although laparoscopic intervention in such patients is associated with a greater likelihood of conversion to open laparotomy, the incidence of major biliary and nonbiliary complications appears to be low. In addition, these patients enjoy the same benefits of laparoscopic surgery as those undergoing elective surgery.