A prospective review of laparoscopic cholecystectomy in Brunei.

ABSTRACT

PIP: Laparoscopic cholecystectomy for the treatment of gallstone disease has the advantages of a shorter postoperative stay, more rapid overall recovery time, and better cosmesis compared to open cholecystectomy. To assess the state of development of laparoscopic cholecystectomy in Brunei, a prospective review of all 220 such procedures performed at the RIPAS Hospital in Bandar Seri Begawan in 1992-96 was conducted. These cases represent the total number of procedures performed in Brunei to date. The standard four-portal technique was used with an open Hasson trocar placed at the umbilicus. 81 patients (37%) were male and 139 (63%) were female; the mean age of patients was 46 years. Indications for the procedure included biliary colic (130 cases), acute cholecystitis (47 cases), and obstructive jaundice caused by gallstones (26). The mean operating time was 109 minutes. 9 patients (4%) required conversion to open surgery. The overall morbidity rate was 5%, with one ductal injury (0.5%). Gallbladder perforation with leakage of bile and/or gallstones occurred in 17% of cases. There was 1 death in this series (0.5% mortality), involving an 87-year-old woman with postoperative bronchopneumonia. 57% of patients did not require any form of analgesia in the postoperative period. The mean hospital stay was 3 days.