Overcoming the difficulties encountered when performing laparoscopic cholecystectomy: review of over one thousand laparoscopic cholecystectomies.

BACKGROUND/AIMS: We assessed the safety of intraoperatively managing the complications that are encountered during laparoscopic cholecystectomy.

METHODOLOGY: From September 2003 to November 2006, one thousand thirty four patients underwent laparoscopic cholecystectomy for benign gallbladder diseases. Laparoscopic cholecystectomy was adopted as the first line treatment for all of these patients regardless of the diagnosis or the presence of previous abdominal operation.

RESULTS

There were 464 male patients and 570 female patients, with a mean age of 53.0 years. Two hundred ninety seven patients (28.7%) had a previous history of abdominal operation. The mean operation time was 51.6 minutes and the mean postoperative hospital stay was 3.8 days. All 9 intraoperative injuries during laparoscopic cholecystectomy were successfully managed by laparoscopic procedures such as choledochocholedochostomy and laparoscopic repair of the injured organ, while no open conversion was required. The complication rate was similar between the patients with or without a previous history of operation.

CONCLUSIONS

Laparoscopic cholecystectomy had been successfully performed without open conversion even in patients with acute cholecystitis or in those who have a previous history of abdominal operation. Most of the complications encountered during laparoscopic cholecystectomy can be managed laparoscopically.