Clinical Review of Laparoscopic Cholecystectomy

ABSTRACT

BACKGROUND: The laparoscopic cholecystectomy has become the treatment of choice for the majority of patients with cholecystopathy. The objectives of this study were to evaluate the safety and the efficacy of the laparoscopic cholecystectomy by reviewing of the case histories of three hundred ten consecutive patients treated with a laparoscopic cholecystectomy. METHODS: We retrospectively analyzed the initial 310 laparoscopic cholecystectomies performed at the Department of General Surgery, Sun General Hospital, from May 1993 to December 1998. Sex, age, associated diseases, previous history of abdominal operation, duration of operation, reason for conversion to open cholecystectomy, hospital stay, and postoperative complications were analyzed. RESULTS: The postoperative diagnosis was chronic cholecystitis in 213 patients, acute cholecystitis in 53 patients, cholesterolosis in 17 patients, gallbladder (GB) empyema in 13 patients, acalculous cholecystitis in 9 patients, and gallbladder carcinomas in 3 patients. The common associated diseases were diabetes mellitus and hypertension. The mean durations of operation, diet, and hospital stay were 77.6 minutes. 1.2 days, and 5 days, respectively. The mean numbers of drainages and injected analgesics were 0.8 and 1.6, respectively. Conversion to an open cholecystectomy was necessary in 8 of the 310 patients (2.6%) who underwent a laparoscopic cholecystectomy either because of severe adhesion (n=6), difficulty with anatomic identification in Calot's triangle (n=1), or severe GB empyema (n=1). The overall postoperative complication rate was 2.6% (8/310). A laparotomy was not required for the treatment of bleeding (5 cases) and residual stones (2 cases). There was no bile duct injury. One patient who had a cerebral infarction died of a cerebrovascular accident. CONCLUSION: We conclude that for benign cholecystopathy the laparoscopic cholecystectomy can be safe and feasible treatment with low morbidity.