Asthma and open cast mining.

15.4 A further study reported success in 51 of 55 patients considered by the surgeon to have acute inflammation, although only nine patients had severe disease.5In our series, conversion to open surgery was required in two patients out of 31 (6%) comparing favourably with the conversion rates in series of elective surgery.'°"We have shown that laparoscopic surgery may be performed safely in severe complicated cholecystitis with minimal morbidity when surgeons have sufficient experience.Patients recover rapidly from the procedure, usually with dramatic resolution of symptoms, and seem to enjoy the same benefits as those undergoing elective surgery.In our experience, about 10% of patients with symptomatic gall stones required emergency surgery for acute cholecystitis which fails to settle on conservative management.As many as a quarter of patients with symptomatic gall stone disease present acutely, and this trend may be increasing.'2Acute cholecystitis constitutes an important and increasing proportion of the surgical workload.We think that these patients should not be denied the benefits of laparoscopic cholecystectomy in centres with appropriate experience.