Laparoscopic cholecystectomy: the Springfield experience.
Laparoscopic cholecystectomy has become an accepted alternative to open cholecystectomy. The purpose of this paper is to review the first 150 laparoscopic cholecystectomies performed at our institution. Hospital and clinic charts were reviewed to obtain demographic information. Anesthesia time and length of hospital stay were recorded. The incidence of intraoperative cholangiogram and laser use were calculated. The type and overall rate of complications were determined, as were complication rates for specific patient subsets. Learning curves by individual surgeons were plotted and hospital costs recorded. Six staff surgeons performed or attempted laparoscopic cholecystectomy on 150 (118 female, 32 male) symptomatic patients. The average age was 43.9 years (range, 18-77). Sixty-five patients (43.3%) had undergone previous abdominal surgery. The average duration of anesthesia was 120.8 min (SD +/- 43.5). Eighteen patients (12.0%) had intraoperative cholangiograms, and 16 procedures (10.7%) employed the laser for dissection. Ten procedures (6.7%) were converted to open cholecystectomy at the discretion of the individual surgeon. Three patients (2.0%) were found to have acute cholecystectomy. Average hospitalization was 1.4 days (SD +/- 1.64). The overall complication rate was 9.3%. Complication rate by age was 7.2% (age < 50 years) versus 13.2% (age > or = 50 years). The complication rate in overweight patients was 15.52% compared with a rate of 5.43% for those not overweight (overweight was arbitrarily defined as > 175 lb for women, > 200 lb for men). The complication rate in patients who had previous abdominal surgery was 8.5% compared with 9.9% in patients who had not had previous abdominal surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Fisher
K S
KS
Southern Illinois University School of Medicine, Department of Surgery, Springfield 62794-9230.
Matteson
K M
KM
Hammer
M D
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000706:statistics & numerical data; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies