title: Multipractice analysis of laparoscopic cholecystectomy in 1,983 patients.
abstract: We analyzed the results of laparoscopic cholecystectomy in 1,983 patients from a variety of practice settings in order to evaluate a large, cross-sectional experience for this new procedure. Twenty general surgeons from 9 clinics in 4 states examined the records and outcome of their laparoscopic cholecystectomy patients through March 1991. In 88 patients (4.5%), the operation was converted to an open procedure, usually because of marked inflammation and unclear anatomy. A total of 644 cases were performed with laser dissection and 1,339 with cautery, and the results of these 2 methods were similar. There were 41 complications. Reoperation for repair was necessary in 18 patients, including 5 with common duct injuries, and, to date, the outcome has been good in each patient. Seventy-six patients (3.8%) have had recognized common duct stones; these were removed preoperatively by endoscopic sphincterotomy (ERS) in 20 patients, during cholecystectomy in 46 patients, and postoperatively by ERS in 4 patients. In six patients, common duct stones became apparent 1 to 4 months after cholecystectomy. We conclude that trained general surgeons can perform laparoscopic cholecystectomy safely with risks comparable to those for conventional open cholecystectomy.
authors.affiliation: Department of Surgery, University of Louisville, Kentucky 40292.
authors.forename: G M
authors.initials: GM
authors.lastname: Larson
authors.forename: G C
authors.initials: GC
authors.lastname: Vitale
authors.forename: J
authors.initials: J
authors.lastname: Casey
authors.forename: J S
authors.initials: JS
authors.lastname: Evans
authors.forename: G
authors.initials: G
authors.lastname: Gilliam
authors.forename: L
authors.initials: L
authors.lastname: Heuser
authors.forename: G
authors.initials: G
authors.lastname: McGee
authors.forename: M
authors.initials: M
authors.lastname: Rao
authors.forename: M J
authors.initials: MJ
authors.lastname: Scherm
authors.forename: C R
authors.initials: CR
authors.lastname: Voyles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000009:adverse effects; D003135:Common Bile Duct / Q000293:injuries; D042882:Gallstones / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged