Lessons learnt after 12 years experience in laparoscopic cholecystectomy at a single center.
OBJECTIVE
This study was conducted to determine the results obtained with laparoscopic cholecystectomy (LC) at the Department of the First Minimal Invasive Surgery and Bile Duct Surgery, Sheng Jing Hospital of China Medical University. The authors compared current six years results with those at the former six years of the experience and developing a guideline.


METHODS
Between May 1997 and May 2009, 2400 LCs were performed at the "Department of the First Minimal Invasive Surgery and Bile Duct Surgery, Sheng Jing Hospital of China Medical University"; 952 patients were operated on between May 1997 and May 2003, and 1,448 between Jun 2003 and May 2009. Data describing the peri-operative interventions, operative methods and maneuvers, complications and methods of preventing them was collected and analyzed.


RESULTS
Mean hospital stay was 3.75 days. Conversion to open surgery was required for 0.46% of cases (11 patients). The surgical complication rate was 0.66%, with the most frequent being bile duct complications (0.42%) and bleeding (0.08%). Two patients died (0.08%). When the results (1997-2003 vs. 2003-2009) were compared, the differences in the history of a previous operation (30 vs. 23.8%, p = 0.001), role of the resident in LC (4.4 vs. 28.2%, p < 0.001), number of LCs for chronic calculous cholecystitis (52.42 vs. 66.16%, p < 0.001), for acute calculous cholecystitis (13.76 vs. 6.5%, p < 0.001) and for gallbladder polyp (32.76 vs. 26.45%, p = 0.001) and mean hospital stay (4.65 vs. 2.85 days, p = 0.034) was observed. In the latter 1448 cases (60.3%), LC was done without the need for routine urinary catheter or gastric tube insertion.


CONCLUSIONS
These results should be interpreted with caution as this is a retrospective study with much uncontrolled bias. We can rely on our practice to accumulate and summarize our experience to formulate perioperative interventions, gradually develop routines management protocols and shorten the learning curve.
Ying
Fan
F
Department of First Minimal Invasive Surgery and Bile Duct Surgery, Sheng Jing Hospital of China Medical University, Shenyang City, Liaoning Province, China 110004.
Shuodong
Wu
W
Hong
Yu
Y
Yang
Su
S
Jing
Kong
K
Yu
Tian
T
Amos
Siwo Ernest
SE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002681:China / Q000453:epidemiology; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies