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XII. Summary and Conclusions
indefinition (54.1%), per-operative haemorrhage (20.8%) and gallbladder
perforation (25%) being responsible for it.
The univaried analysis of the various factors previously considered, led
us to conclude the following: absence of significant difference with regards
to age, sex, choledocho-lithiasis, acute pancreatitis, associated diseases, ASA,
pain in the right hypochondrium, sickness, jaundice, galbladder pathology
galbladder diameter and Murphy signal.
However, parameters of significant value were verified in relation
to:presence of palpable gallbladder, temperature above 38°C, leucocytosis above
15000, time elapsing between diagnosis and surgery (over 4 days), presence
in ecography of edema and peri-cholecystic liquid.
Although the bacteriobilia in the 2 groups was not important, in the
converted the presence of "Klebsiella" was significant.
The multifactor analysis allowed us to identify as independent factors
leucocytosis over 15000 and the time elapsing between diagnosis and surgery.
The comparative analysis of groups AI and A2 (although without
statistical value) revealed more morbidity in converted (6.5% in Al and 20.8%
in A2) and longer hospital stay (4.2 in AI and 7.7 in A2); there was no operative
mortality in any of the series.
The clinical results obtained at length were similar in both groups.
For all these reasons, we think we can state that in spite of the scepticism
with which laparoscopic cholecystectomy in acute cholecystitis was regarded
until a short time ago, it deserves to occupy a privileged place as an option
in the treatment of galbladder affections. However, it is important to stress
the unquestionable advantages of performing it as early as possible, the only
way to reduce the incidence of conversion.
It is never too much to stress that, despite that, in view of the technical
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