Laparoscopic cholecystectomy in 2,750 cases in a teaching hospital in Kuwait.

OBJECTIVE: To retrospectively analyse all laparoscopic cholecystectomies performed between April 1992 and May 1999. METHODS: Medical records of 2,750 patients, clinically diagnosed with gall bladder disease, were reviewed. We analysed the operative time, length of postoperative hospital stay, conversion rate, intra- and postoperative complications as well as management outcome. RESULTS: The mean operative time was 59.2 min, and the mean postoperative hospital stay was 1.46 days. However, the majority of our patients (66.8%) were discharged after 1 day. The conversion rate was 3.8%, which was mainly due to acute gall bladder pathology. The postoperative complication rate was 4.6%; all cases were managed successfully with no mortality or delayed morbidity. CONCLUSION: Our findings indicate that laparoscopic cholecystectomy appears to be a safe and effective procedure with low morbidity and no mortality. Therefore, it should be considered as the procedure of choice for patients with gall bladder disease.

Is laparoscopic cholecystectomy a safe procedure for patients receiving anticoagulant therapy?

OBJECTIVE: To evaluate the safety of laparoscopic cholecystectomy (LC) in patients on oral anticoagulant therapy. METHODS: Four patients were involved in this study on whom the procedure was performed in a conventional manner paying meticulous attention to haemostasis. The oral anticoagulant was resumed the night of the operation, and the patient was discharged and acceptable international normalised ratio was achieved postoperatively. RESULTS: There was no thrombo-embolic or haemorrhagic complication. The mean hospital stay was 5 days. CONCLUSION: LC can be safely performed in patients on oral anticoagulant therapy.