Overcoming the difficulties encountered when performing laparoscopic cholecystectomy: review of over one thousand laparoscopic cholecystectomies.
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.
Chun
Kwang-Sik
KS
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
Han
Ho-Seong
HS
Yoon
Yoo-Seok
YS
Cho
Jai Young
JY
Kim
Ji Hoon
JH
Ahn
Keun Soo
KS
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