Effects of a cystic artery–first Calot’s triangle laparoscopic approach versus conventional laparoscopic cholecystectomy on therapeutic efficacy and complications in acute cholecystitis

BACKGROUND: Acute cholecystitis (AC) is a common biliary disorder, most often caused by gallstones obstructing the cystic duct and leading to gallbladder inflammation. OBJECTIVES: This study aimed to compare the therapeutic efficacy and complication rates of laparoscopic cholecystectomy (LC) performed using the Calot's triangle approach vs traditional LC techniques in the treatment of AC. MATERIAL AND METHODS: A retrospective analysis was conducted on 120 patients diagnosed with AC, with 60 patients undergoing LC using the Calot's triangle approach (study group) and 60 patients treated with traditional LC techniques (control group). Surgical parameters, including operation time, intraoperative hemorrhage, postoperative recovery times, and 30-day postoperative complications were recorded. Intraoperative adhesion formation was evaluated through direct visualization and graded based on severity. Postoperative pain was assessed using the visual analogue scale (VAS). RESULTS: There was no statistically significant difference in the baseline characteristics between the 2 groups, confirming their comparability. The study group (Calot's triangle approach) demonstrated significantly shorter average operation time, postoperative exhaust time, and diet recovery time compared to the control group. Additionally, patients in the study group had significantly lower intraoperative bleeding, lower VAS pain scores at 24 h and 72 h postoperatively, and a lower overall complication rate compared to the control group (p < 0.05). CONCLUSIONS: The LC Calot's triangle approach demonstrated shorter operation times and lower rates of certain complications compared with traditional LC techniques. However, the absence of statistically significant differences in some key outcomes highlights the need for further research to fully evaluate its clinical advantages and long-term benefits.