FAVORABLE RESULTS WITH LAPAROSCOPIC CHOLECYSTECTOMY

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FAVORABLE RESULTS WITH LAPAROSCOPIC CHOLECYSTECTOMY.

An AMA panel recently gave a favorable review for laparoscopic cholecystectomy, the latest innovation in the surgical treatment of gallbladder disease (see JW accession number 910402005). Now a large case series supports the panel's conclusions.

Over 1500 laparoscopic cholecystectomies were performed by 59 surgeons with no contractual ties to instrument manufacturers. In 5 percent of cases, factors such as inflammation or adhesions led to conversion to conventional open cholecystectomy during the procedure. Five percent of the patients had complications, including wound infection (1 percent), bile duct injury (0.5 percent), and retained common duct stones (0.4 percent). Complication rates were unrelated to the use of either laser dissection or cautery and were similar in teaching and nonteaching hospitals. Only one patient died postoperatively (from a ruptured aortic aneurysm), and cardiopulmonary complications were virtually nil. The mean duration of hospitalization was 1.2 days.

These results provide reassurance that the rapidly expanding use of laparoscopic cholecystectomy is justified. Complication rates compare favorably with those of conventional cholecystectomy, and the short hospital stay and rapid recuperation time are decided advantages of the new procedure.

— ASB

Published in Journal Watch General Medicine April 23, 1991