title: Overcoming the difficulties encountered when performing laparoscopic cholecystectomy: review of over one thousand laparoscopic cholecystectomies.
abstract: OBJECTIVE
  We assessed the safety of intraoperatively managing the complications that are encountered during laparoscopic cholecystectomy.
  
  
  METHODS
  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.
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kwang-Sik
authors.initials: KS
authors.lastname: Chun
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Keun Soo
authors.initials: KS
authors.lastname: Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors