title: [A prospective evaluation of laparoscopic cholecystectomy in the treatment of chronic cholelithiasis--a five-year experience].
abstract: BACKGROUND
  Laparoscopic cholecystectomy is a method of choice in the treatment of symptomatic cholecystolithiasis because of less postoperative pain, shorter hospitalization and lower cost of treatment. The study was aimed at analysing the outcome of laparoscopic cholecystectomy in patients surgically treated for chronic calculous cholecystitis (symptomatic cholelithiasis).
  
  
  METHODS
  The research was done in the period from December 2003 to December 2008. In the prospective study of 386 patients, we analyzed operative and postoperative complications, the reasons for conversion to open cholecystectomy, duration of hospitalization and mortality.
  
  
  RESULTS
  The average duration of laparoscopic cholecystectomy was 31.9 +/- 14.5 min: dissection of adhesions 3.2 +/- 0.7 min., elements of Calot's triangle 9.8 +/- 3.2 min., gallbladder releasing from its bed 12.8 +/- 2.8 min., the abdominal cavity lavage and removal of gallbladder from the abdomen 6.8 +/- 0.9 min. Some operative difficulties emerged in 22 (5.7%) patients--4 (1%) during releasing of gallbladder adhesions from the surrounding structures, 9 (2.3%) during dissection of elements of the Calot's triangle, 6 (1.5%) during gallbladder releasing from its bed, 3 (0.7%) during gallbladder removal from the abdomen. Some post-operative complications, single or associated, occurred in 36 (9.3%) patients: perforation of gallbladder 21 (5.4%), bleeding from gallbladder bed 18 (4.6%)/ injury of extra hepatic bile ducts 1 (0.20%), 9 (2.3%) spillage of stones; 3 (0.7%) conversions were made. The average duration of preoperative and postoperative hospitalization was 1.1 +/- 0.3 and 1.4 +/- 0.5 days, respectively. The pathohistological examination revealed 2 (0.5%) adenocarcinoma of gallbladder. There were no lethal outcomes.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy is a safe procedure and rational choice in the treatment of biliary dyskinesia and symptomatic biliary calculosis with an acceptable rate of conversion.
authors.affiliation: Hirursko odeljenje, Opsta bolnica Berane, Crna Gora. vesa@t-com.me
authors.forename: Veselin
authors.initials: V
authors.lastname: Stanisić
authors.forename: Milorad
authors.initials: M
authors.lastname: Bakić
authors.forename: Milorad
authors.initials: M
authors.lastname: Magdelinić
authors.forename: Hamdija
authors.initials: H
authors.lastname: Kolasinac
authors.forename: Darko
authors.initials: D
authors.lastname: Vlaović
authors.forename: Blazo
authors.initials: B
authors.lastname: Stijović
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002769:Cholelithiasis / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D055815:Young Adult