Complications After Laparoscopic and Conventional Cholecystectomy: A Comparative Study

The growing popularity of laparoscopic cholecystectomy (LC) has made extensive seriescomparing laparoscopic and conventional cholecystectomy in a prospective, randomized waynearly impossible. To evaluate LC we compared retrospectively 800 laparoscopic with 748conventional cholecystectomies (CC). Of the 800 LC, 10 (1.2%) were converted to laparotomy.6 conversions were related to aberrant anatomical features or features making dissection verydifficult, 4 conversions were due to complications. There were 5 (0, 6%) intraoperative complicationsduring LC and 4 (0.5%) during CC. Postoperative morbidity was 2.1% (n = 17) after LCand 3.7% (n = 28) after CC. Particularly the incidence of wound problems was only 0.5% (n = 4)after LC while it was 1.3% (n = 10) after CC. Overall morbidity was 2.7% (n = 22) for LC and4.2% (n = 32) for CC. Mortality rate after CC was 0.4% (n = 3), there were no deaths after LC.Common bile duct-injury rate was 0.2% (n = 2) for both groups. Complication rates after LChave been rapidly decreasing with growing experience. Laparoscopic cholecystectomy can safelybe performed by appropriately trained surgeons in more than 90% of patients suffering fromgallbladder disease. The low morbidity and mortality together with the significant advantages topatient recovery makes laparoscopic cholecystectomy the treatment of choice for symptomaticcholecystolithiasis.