Mustafa Biomy and Eslam M. Ibrahim
Tamer Alsaied Alnaimy , Tamer Rushdy Elalfy and Mohammed A.Elkilany
Ahmed Mahmoud Hussein1 M.D.; Ahmed Abd Alaziz Mohammad1 M.D.; Ahmed Mohammed Ahmed Nasser2 M.Sc.
Sherif Essam Eldin Tawfik, MD; Abdelrahman Mohamed Salem, MD
Abdelrahman Mohammed, MD, Ahmed Kamal Gabr, MD, Sherif Essam Eldin Tawfik, MD
Ashraf Elsebaie MD, Ahmed Abdelsalam Hafiz MD, Ahmed Maher MD, Rasha Abdelkader MD
Ahmed M.S.M Marzouk, Haitham S. Omar
Hany F. Habashy
Maged Rihan, MD, MRCS
Karim Sabry (MD, MRCS) , Wael A Jumuah (MD) ,Yasser El Ghamrini (MD)
Ahmed Shoka, MD, MRCS, Fady Makram, MD, FACS, Mohamed Matar, MD, FACS.
Mohammed Matar,1 MD, FACS, Ahmed Shoka,1 MD, MRCS, Heba Nader,2 MD
Mokhtar Abd Elrahman Bahbah, MD; Ehab M Oraby, MD.
Youssif Khachaba, Waleed Reda, Ahmed Abd El Salam, Ahmed Samy Saad Hussein, Nadeen Mohamed El Essawy, Ashraf El Sebaie
Naguib Abdelkreem ElAskary MD, Ahmed Osmane MD
Mahmoud Hamda MS, Naguib Abdelkreem ElAskary MD, Ahmed Osmane MD
Ahmed M.S.M. Marzouk
1Waleed AlBadry, MSc, MRCS;1Raafat Gohar, MD; 1Ashraf El-Sebaie; 2Mohamed Salah, MD;1Mohamed Ashraf El Meleigy, MD
Complicated Acute Cholecystitis; Protocol of Management
Objectives: To evaluate the outcome of management plan for acute cholecystitis (AC) patients according to
patients' general condition and disease severity. Patients & Methods: advanced cases of acute cholecystitis
(grades II-III) were evaluated for fitness for general anesthesia (GA) according to criteria of American
Society of Anesthesiologists and fit patients underwent laparoscopic cholecystectomy (LC), while unfit
patients underwent percutaneous cholecystostomy (PC). Results: Eighteen fit patients underwent LC; two
patients (11.1%) required open conversion. 13 patients developed PO morbidities, but only two
complications were surgery-related. Only one patient died secondary to surgery-related cause (MR of
5.6%). Eight patients underwent PC; 6 patients developed PO morbidities and one patient died during
hospital stay due to surgery related cause (MR of 12.5%). Patients had PC or LC showed non-significant
difference as regards time till 1st ambulation or oral intake and for ICU stay, but PC patients required
significantly longer hospital stay (12.6 vs. 14.6 days). Conclusion: LC is effective definitive therapy if
patient was fit for GA. For patients who are unfit for GA, PC is a feasible, safe and effective option with
acceptable outcomes.
Keywords: Acute cholecystitis, Laparoscopic cholecystectomy, percutaneous cholecystostomy, Mortality
rate.