Abstract: Objective To study the difficulties and countermeasures of laparoscopic-assisted resection of difficult gallbladder with inflammation and edema. Methods A total of 120 patients with acute cholecystitis admitted to the hospital from January 2018 to January 2021 were selected. They were divided into a minimally invasive group （n=60） and an open group （n=60） by single and double digit method. Conventional open cholecystectomy was performed in the open group, and laparoscopic cholecystectomy （LC） was performed in the minimally invasive group. The surgical indicators, postoperative complications, serum CRP, white blood cell count, and percentage of granulocytes were compared between the two groups. Results In the minimally invasive group, the operation duration, intraoperative blood loss, intestinal sound recovery time, anal exhaust time, indwelling drainage tube time, and hospital stay were （61.89±3.56） min, （30.79±2.16） mL, （17.89±2.47） h, （23.86±1.89） h, （2.45±0.51） d, and （4.72±0.75） d, respectively, which were lower than those in the open group, （80.03±6.18） min, （42.12±2.49） mL, （32.12±3.69） h, （40.57±4.26） h, （3.66±0.72） d, and （7.06±0.94） d, respectively （all P<0.05）. The total incidence of complications in the minimally invasive group was lower than that in the open group （3.33% vs. 13.33%） （P<0.05）. There were no significant differences in serum CRP, white blood cell count, and percentage of granulocytes between the two groups 1 d before operation （all P>0.05）. One day after surgery, the serum CRP, white blood cell count, and percentage of granulocytes in the minimally invasive group were （32.84±4.19） mg/L, （12.46±2.30）×10⁹/L, and （77.86±7.28）%, respectively, lower than those in the open group, （51.78±6.26） mg/L, （15.17±3.06）×10⁹/L, and （83.47±8.09）%, respectively （all P<0.05）. Conclusion Laparoscopic-assisted resection of difficult gallbladder with inflammation and edema has a significant effect, which can promote the early recovery of patients, reduce the risk of postoperative complications, and reduce inflammatory reaction.

Key words: Acute cholecystitis, Laparoscopic cholecystectomy, Inflammation and edema, C-reactive protein, White blood cell count, Percentage of granulocytes