Laparoscopic management of acute cholecystitis. Prognostic factors for success.

Background: Laparoscopic cholecystectomy for acute cholecystitis is considered feasible and safe, but it is associated with a higher rate of conversion to laparotomy than elective cholecystectomy because of technical reasons and anatomical changes related to the inflammatory process. The value of several factors that might influence its successful completion has not been studied completely yet, including the role of residents in operating such cases under attending-surgeon surveillance.

Methods: In a retrospective nonrandomized study, the medical charts of 182 patients that were operated for acute cholecystitis (94 of whom via the laparoscopic approach) were studied.

A technique for second-look laparoscopy in the obese patient.

A technique for second-look laparoscopy in an obese patient suffering from acute mesenteric ischemia is described. A device composed of a 10-mm trocar-sleeve and a large Foley catheter was used, which enables its proper fixation through the abdominal wall, without causing any intestinal damage.