The Feasibility and Safety of Laparoscopic Cholecystectomy in Cases of Acute Calculus Cholecystitis in Jalalabad Ragib Rabeya Medical College, Sylhet

Open Access

Abstract

Background: Gallstone disease frequently leads to surgical admissions, particularly among women and individuals with metabolic risk factors. This study aimed to evaluate the feasibility and safety of laparoscopic cholecystectomy in the management of acute calculous cholecystitis. Methods & Materials: This hospital-based observational study included 135 consecutive patients with acute calculus cholecystitis who underwent attempted laparoscopic cholecystectomy at Jalalabad Ragib Rabeya Medical College, Sylhet, from July 2022 to July 2025. Diagnosis was based on clinical features, with supportive laboratory inflammation and ultrasonographic evidence of gallstones with acute cholecystitis. Feasibility outcomes were laparoscopic completion, conversion, and bailout use, while safety outcomes were 30-day complications, particularly bile leak and surgical site infection, plus ICU or HDU need; length of stay was also recorded. Data were analyzed descriptively in SPSS v26, and ethical approval with anonymized record handling was ensured. Results: Among 135 patients, mean age was 44.2 ± 13.6 years, 71.1% were female, and mean BMI was 25.1 ± 3.4 kg/m². Most were ASA II (51.9%), with hypertension (30.4%) and diabetes (23.7%) common. Laparoscopic completion was achieved in 89.6%, with 10.4% conversion to open surgery. Mean operative time was 78.6 ± 24.5 minutes and median blood loss 80 ml. Overall complication rate was 16.3%, including bile leak (3.0%) and SSI (6.7%). ICU/HDU care was required in 4.4% of cases, with 35.6% discharged within 48 hours. Conclusion: Laparoscopic cholecystectomy for acute calculus cholecystitis was feasible and safe, showing high completion rates, acceptable conversion rates, low bile leak and infection rates, and good outcomes supported by effective safety measures and bailout strategies.