Minimally Invasive Surgical Approach for Severe Acute Cholecystitis – Integrative Review
DOI:
https://doi.org/10.24859/SaberDigital.2025v18n2.1710Keywords:
Acute Cholecystitis, Surgical Treatment, Minimally Invasive Procedures, CholecystectomyAbstract
Introduction: Inflammation of the gallbladder is called cholecystitis, which can occur in acute or chronic forms, primarily affecting the elderly and patients with dyslipidemia. In its severe form, it can cause intense pain and lead to complications such as gallbladder perforation and sepsis. Objective: To review minimally invasive surgical practices in the management of severe acute cholecystitis (SAC), assessing their efficacy and clinical implications. Methodology: Integrative review based on searches in PubMed and BVS databases, including studies from 2004 to 2024, in Portuguese and English. Ten articles were selected after applying inclusion and exclusion criteria. Results and Discussion: Percutaneous cholecystostomy was effective in relieving symptoms in critically ill patients, reducing complications and hospital stay duration. Strategies to minimize conversion in laparoscopic cholecystectomy proved effective in reducing conversion rates to open surgery. The minilaparotomy technique demonstrated lower costs and a good success rate, whereas laparoscopy showed a higher risk of biliary injuries. Robotic cholecystectomy offers potential benefits but lacks robust evidence. Conclusion: Minimally invasive approaches, such as percutaneous cholecystostomy and improvements in laparoscopy, are promising alternatives for SAC, especially in high-risk patients. Future research should further explore the role of robotic surgery.
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