Laparoscopic cholecystectomy at Dr-Soliman Fakeeh hospital: the first year experience

ABSTRACT

A retrospective study of the first year experience with laparoscopic cholecystectomy at Dr. Sulayman Fakeeh Hospital, Jaddah, Saudi Arabia, between November 1, 1991 and October 31, 1992 was presented. Laparoscopic cholecystectomy was attempted in 98.4% of patients [n = 250] presented with primary gallbladder disease and was completed in 94.8%. Conversion to open cholecystectomy was necessary in 13 patients [5.3%] either because of technical difficulty [n = 9], the onset of complications [n = 2], or unclear anatomy [n = 2]. There were no deaths and the total postoperative complication rate was 14 out of 237 [5.9%], with 2 [0.8%] being serious complication requiring laparotomy. The total incidence of bile duct injury was 3 out of 246 [1.1%]. The mean operating time for all cases was 89.4 +/- 39.4 minutes and it improved significantly from the first 10 cases to the last 10 cases [125.5 +/- 24.5 minutes versus 33.5 +/- 7.8 minutes respectively]. Electrocautery was used in all cases. Postoperative narcotic requirements were limited to oral or no-medications in about 78.9%. 80% of patients were discharged within 24 hours of surgery and 78% were able to tolerate regular diet by the morning following the procedure. About 48% of patients required the insertion of a suction drainage which were nearly removed by the second postoperative day. The mean time for return to full activity was 11.5 +/- 5.9 days after operation. Analysis of hospital costs revealed a saving of about 600 dollars for laparoscopic cholecystectomy when compared to an open, uncomplicated cholecystectomy. Follow-up for 3 months of the patients revealed that they were satisfied with the procedure and were doing well