title: [Development of laparoscopic technology in biliary surgery in the past 23 years: a single-center experience].
abstract: OBJECTIVE
  To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases.
  
  
  METHODS
  We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point.
  
  
  RESULTS
  The 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05).
  
  
  CONCLUSIONS
  Laparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.
authors: Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing 100853, China. E-mail: shihaida0211@163.com.
authors: Hai-da
authors: HD
authors: Shi
authors: Xian-Jie
authors: XJ
authors: Shi
authors: Shao-Cheng
authors: SC
authors: Lv
authors: Huan-Xian
authors: HX
authors: Ma
authors: Yu-Rong
authors: YR
authors: Liang
authors: Lin
authors: L
authors: Zhou
authors: Yong
authors: Y
authors: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic; D002648:Child; D017081:Cholecystectomy, Laparoscopic; D004322:Drainage; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult