LAUSR

Laparoscopic cholecystectomy for acute cholecystitis (‘hot gallbladder’) is known to be associated with increased operative difficulty and a higher risk of intraoperative biliovascular complications. Certain bailout strategies have been formulated to mitigate these risks. The aim of this study is to evaluate the bailout rate of early cholecystectomy in acute cholecystitis. Data was collected over a three-year period (February 2022 to January 2025) on patients who were booked for ‘urgent’ or ‘very urgent’ laparoscopic cholecystectomy for acute cholecystitis. Data analysis was done with IBM SPSS Statistics 29.0.1.0. A total of 190 patients (age range 22 - 96 years, mean 53.4) underwent surgery within six weeks of initial presentation with acute cholecystitis. The mean intraoperative difficulty score on a scale of 1 – 4 was 2.35, with operative times ranging from 25 to 210 minutes (mean 83.25 minutes). Six patients (3.2%) required subtotal cholecystectomy while five (2.6%) had procedures abandoned due to intraoperative difficulties. There were no conversions to open cholecystectomy or need for percutaneous cholecystostomy drain insertion. The overall bailout rate was 5.8%, with no surgery-related mortality. Early laparoscopic cholecystectomy for acute cholecystitis is a safe procedure with a low bailout rate, demonstrating its feasibility as an effective option for managing this condition.