Laparoscopic cholecystectomy How to guard against complications?

ABSTRACT

Forty patients underwent laparoscopic cholecystectomy during the period from December 1991 through August 1992, they were 32 women and 8 men median age 38 [range 21-61 years]. Three patients of late cases were acute, the rest were chronic. Conversion to open cholecystectomy was required in two patients [5%] because of bleeding from deep branch of cystic artery and technical difficulties with the dissection. Neither deaths nor common bile duct injury were encountered in this study. Bleeding occurred in three patients, two of them needed blood transfusion. Mean operating time was reduced gradually, time for initial 20 patients was compared to last 20 patients [154 + or 32 minutes versus 80 + or 24.5 minutes, respectively]. Postoperative jaundice occurred in one patient due to retained stone that was managed by endoscopic sphinctrotomy. Mean hospital stay was 1.9 + or 0.3 days, and mean time to return to full activity was 12.2 +/- 5 days after operation. For this, laparoscopic cholecystectomy becomes the procedure of choice for most patients with gall stones and will continue to evolve as more experience is gained and new instruments are introduced