Initial experiences with laparoscopic cholecystectomy

Laparoscopic cholecystectomy was performed in 45 patients for treatment of symptomatic gallbladder disease. The age distribution was 23 to 79 years. In four patients the procedure was not completed and a laparotomy was performed to remove the gallbladder: once because of a defective instrument, once because of bleeding of an omental adhesion and twice because of disturbed anatomy of the cystic duct region by inflammatory tissue. In four cases a laparoscopic cholecystectomy was performed because of an acute cholecystitis and in three cases a laparoscopic cholecystectomy à froid was performed. There were three postoperative complications: one case of bleeding and two cases of leakage of bile during five and ten days, respectively. In all these cases the treatment was conservative and laparotomy was not necessary. The postoperative hospital stay varied between 3 and 11 days with a mean of 4.2 days. The period of unfitness for work after leaving hospital ranged from one to three weeks. If for whatever reason the laparoscopic procedure cannot be completed, a laparotomy to remove the gallbladder should be performed in the same session. Laparoscopic cholecystectomy is a new, safe, less invasive method to remove the gallbladder with significant benefit to the patient. The morbidity is low and the hospital stay is short. A considerable reduction of costs is achieved with this treatment.