Outcome evaluation of 10,317 laparoscopic cholecystectomies: a 17-year experience at a single center.
OBJECTIVE
This study is an analysis of the large series of laparoscopic cholecystectomies and compare our results with those reported in the literature concerning complications.


METHODS
From December 1993 to September 2010, 10,317 patients with gallstone disease underwent laparoscopic cholecystectomy. Previously operated patients were also included in the study. We analyzed the successfulness of the results, intraoperative and postoperative complications, conversions in open cholecystectomy, mortality and reoperation rate.


RESULTS
We registered 23.28% complications. Intraoperative complications were bleeding in 9.84%, gallbladder perforation in 8.63%, stone loss in 1.37%, common bile duct injury in 0.24% and injury of intraabdominal organs in 0.07% of cases. Postoperative complications were bleeding in 1.12%, wound infection in 0.59%, bile leakage in 0.5%, incisional umbilical hernias in 0.37%, subhepatal collection in 0.33%, residual gallstones in choledocus in 0.09%, urine retention in 0.08% and biliary peritonitis in 0.01% of patients. Conversion to open cholecystectomy was necessary in 2.13%. Reoperation was performed in 0.27%. The mortality rate was 0.019%.


CONCLUSIONS
Our results on large number of patients are similar to other series in the newer literature but the rate of complications should be decreased. The incidence of complications decreases with growing laparoscopic experience.
Harry
H
Grbas
Leon
L
Kunisek
Marko
M
Zelić
Nenad
N
Petrosić
Ivica
I
Cepić
Aleksandra
A
Pirjavec
Franjo
F
Lovasić
Miljenko
M
Uravić
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000401:mortality; D017523:Croatia; D005260:Female; D042882:Gallstones / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult