Laparoscopic Cholecystectomy for Acute Cholecystitis: An Evidence-Based Review

Abstract

Laparoscopic cholecystectomy (LC) is currently considered the standard treatment for acute cholecystitis, although controversies persist regarding optimal timing, management of severe disease, and treatment in high-risk populations. This review summarizes current evidence on the effectiveness, safety, and indications of LC compared with open surgery and percutaneous drainage. Available data consistently demonstrate that LC is associated with lower morbidity, mortality, and shorter hospital stay compared with open cholecystectomy. Early LC is generally favored, as it reduces complications and overall hospitalization. However, in severe inflammation or high-risk patients, complication rates and conversion to open surgery increase, and alternative strategies such as percutaneous cholecystostomy may be appropriate. Outcomes are strongly influenced by surgical expertise and patient selection. Overall, LC remains the preferred treatment for most patients with acute cholecystitis, provided that appropriate clinical judgment and bailout strategies are applied in complex cases.