Surgical aspects of symptomatic cholecystolithiasis and acute cholecystitis

Introduction of laparoscopic cholecystectomy was extremely fast. Although nowadays surgical treatment – and cholecystectomy in particular – is difficult to imagine without laparoscopy, from a scientific point of view true evidence of its superiority over small-incision or open cholecystectomy is lacking. A lot of controversy exist both on intraoperative cholangiography and antibiotic prophylaxis, but generally selective use is recommended. The overall complication rate for all the three surgical techniques is considerable. The number of bile-duct injuries has risen after the introduction of laparoscopic cholecystectomy, but this major individual burden is taken for granted in relation to the advantage of a quicker convalescence in the vast majority of patients. New developments such as robot-assisted cholecystectomy may play a more dominant role in the near future.Diagnosis of acute cholecystitis is by a combination of clinical signs supported by radiological evaluation. Progress to gangrene or (free) perforation can be quick and is associated with complications. High-quality literature on (surgical) treatment of acute cholecystitis is lacking, mainly because of the relatively low incidence of this disease. The three surgical techniques available seem equally safe, but overall complications and conversions are higher and convalescence takes longer period compared to symptomatic cholecystolithiasis. The available literature indicates that early acute cholecystectomy is the preferred treatment, primarily because of a shorter period of sickness. Cholecystostomy is reserved for patients with severe co-morbid conditions, especially in the setting of acute acalculous cholecystitis.

Symptomatic cholecystolithiasis

• the laparoscopic and the small-incision operations should be considered equal (apart from a quicker operative time with the small-incision technique); both minimally invasive techniques have advantages over the open operation with respect to postoperative recovery

• correct patient selection is important for achieving low failure rates of symptom relief

• selective use of intraoperative cholangiography and antibiotic prophylaxis is advised

Acute cholecystitis

• open, small-incision and laparoscopic cholecystectomies seem equally safe, although available data are scarce

• early surgery is preferred over delayed cholecystectomy because of shorter hospital stay and convalescence

• the use of intraoperative cholangiography and antibiotic prophylaxis in cholecystectomy for symptomatic cholecystolithiasis should be elucidated by more extensive research

• potential differences in outcome after open, small-incision and laparoscopic cholecystectomies for acute cholecystitis need further research

References

*1 NIH Consensus conference, Gallstones and laparoscopic cholecystectomy, JAMA 269 (1993) (8), pp. 1018–1024.

2 J.E. Everhart, M. Khare and M. Hill et al., Prevalence and ethnic differences in gallbladder disease in the United States, Gastroenterology 117 (1999) (3), pp. 632–639. Article | 3 A.F. Attili, N. Carulli and E. Roda et al., Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL), Am J Epidemiol 141 (1995) (2), pp. 158–165. View Record in Scopus | Cited By in Scopus (99)

4 K.H. Jensen and T. Jorgensen, Incidence of gallstones in a Danish population, Gastroenterology 100 (1991) (3), pp. 790–794. View Record in Scopus | Cited By in Scopus (57)

*5 J.J. Roslyn, G.S. Binns and E.F. Hughes et al., Open cholecystectomy. A contemporary analysis of 42,474 patients, Ann Surg 218 (1993) (2), pp. 129–137. View Record in Scopus | Cited By in Scopus (164)

6 A.P. Legorreta, J.H. Silber and G.N. Costantino et al., Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy, JAMA 270 (1993) (12), pp. 1429–1432. View Record in Scopus | Cited By in Scopus (152)

7 C.J.A. Langenbuch, Ein Fall von Extirpation Gallenblase wegen chronischer Cholelithiasis: Heilung, Berl Klin Wochenschr 19 (1882), pp. 725–727.

8 D.E. Johnston and M.M. Kaplan, Pathogenesis and treatment of gallstones, N Engl J Med 328 (1993) (6), pp. 412–421. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (79)

9 F. Dubois and B. Berthelot, Cholecystectomy through minimal incision [author's transl], Nouv Presse Med 11 (1982) (15), pp. 1139–1141. View Record in Scopus | Cited By in Scopus (33)

10 I.R. Goco and L.G. Chambers, ‘Mini-cholecystectomy’ and operative cholangiography. A means of cost containment, Am Surg 49 (1983) (3), pp. 143–145. View Record in Scopus | Cited By in Scopus (14)

11 G. Moss, Discharge within 24 hours of elective cholecystectomy. The first 100 patients, Arch Surg 121 (1986) (10), pp. 1159–1161. View Record in Scopus | Cited By in Scopus (18)

12 P.J. O'Dwyer, J.J. Murphy and N.J. O'Higgins, Cholecystectomy through a 5 cm subcostal incision, Br J Surg 77 (1990) (10), pp. 1189–1190. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (22)

13 D.O. Olsen, Mini-lap cholecystectomy, Am J Surg 165 (1993) (4), pp. 440–443. Abstract | View Record in Scopus | Cited By in Scopus (10)

14 N.S. Tyagi, M.C. Meredith and J.C. Lumb et al., A new minimally invasive technique for cholecystectomy. Subxiphoid ‘minimal stress triangle’: microceliotomy, Ann Surg 220 (1994) (5), pp. 617–625. View Record in Scopus | Cited By in Scopus (10)

15 E. Mühe, Die erste Cholecystektomie durch das laparoskop, Langenbecks Archiv für Chirurgie 369 (1986), p. 804. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (77)

16 F. Dubois, G. Berthelot and H. Levard, Cholecystectomy with celioscopy. 330 Cases, Chirurgie 116 (1990) (3), pp. 248–250. View Record in Scopus | Cited By in Scopus (10)

17 J. Perissat, D. Collet and R. Belliard et al., Laparoscopic cholecystectomy. Surgical technique and results of the first 100 operations, Chirurg 61 (1990) (10), pp. 723–728. View Record in Scopus | Cited By in Scopus (5)

18 A.T. Spaw, E.J. Reddick and D.O. Olsen, Laparoscopic laser cholecystectomy: analysis of 500 procedures, Surg Laparosc Endosc 1 (1991) (1), pp. 2–7. View Record in Scopus | Cited By in Scopus (51)

19 E. Neugebauer, H. Troidl and W. Spangenberger et al., Conventional versus laparoscopic cholecystectomy and the randomized controlled trial. Cholecystectomy Study Group, Br J Surg 78 (1991) (2), pp. 150–154. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (72)

20 M.J. Moore and C.L. Bennett, The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club, Am J Surg 170 (1995) (1), pp. 55–59. View Record in Scopus | Cited By in Scopus (173)

21 E. Neugebauer, H. Troidl and C.K. Kum et al., The E.A.E.S. consensus development conferences on laparoscopic cholecystectomy, appendectomy, and hernia repair, Surg Endosc 9 (1995) (5), pp. 550–563. View Record in Scopus | Cited By in Scopus (80)

22 E.A. Scott and N. Black, Appropriateness of cholecystectomy: the public and private sectors compared, Ann R Coll Surg Engl 74 (1992) (4 Suppl.), pp. 97–101. View Record in Scopus | Cited By in Scopus (7)

*23 D.J. Deziel, Complications of cholecystectomy. Incidence, clinical manifestations, and diagnosis, Surg Clin North Am 74 (1994) (4), pp. 809–823. View Record in Scopus | Cited By in Scopus (61)

24 D.G. Affleck, D.L. Handrahan and M.J. Egger et al., The laparoscopic management of appendicitis and cholelithiasis during pregnancy, Am J Surg 178 (1999) (6), pp. 523–529. View Record in Scopus | Cited By in Scopus (56)

25 E.J. Grau-Talens, F. Garcia-Olives and M.P. Ruperez-Arribas, Transcylindrical cholecystectomy: new technique for minimally invasive cholecystectomy, World J Surg 22 (1998) (5), pp. 453–458. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (5)

26 R.S. Smith, W.R. Fry and E.K. Tsoi et al., Gasless laparoscopy and conventional instruments. The next phase of minimally invasive surgery, Arch Surg 128 (1993) (10), pp. 1102–1107. View Record in Scopus | Cited By in Scopus (69)

27 Y.W. Novitsky, K.W. Kercher and D.R. Czerniach et al., Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial, Arch Surg 140 (2005) (12), pp. 1178–1183. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (18)

28 S. Trichak, Three-port vs standard four-port laparoscopic cholecystectomy, Surg Endosc 17 (2003) (9), pp. 1434–1436. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (14)

29 M.S. Metcalfe, T. Ong and M.H. Bruening et al., Is laparoscopic intraoperative cholangiogram a matter of routine?, Am J Surg 187 (2004) (4), pp. 475–481. Article | 30 S.A. Stuart, T.I. Simpson and L.A. Alvord et al., Routine intraoperative laparoscopic cholangiography, Am J Surg 176 (1998) (6), pp. 632–637. Article | 31 J.K. Derodra, A.R. Jackson and W.G. Prout, Quality and interpretation of operative cholangiography in a district general hospital, J R Coll Surg Edinb 37 (1992) (4), pp. 241–243. View Record in Scopus | Cited By in Scopus (3)

32 J.C. Silverstein, E. Wavak and K.W. Millikan, A prospective experience with selective cholangiography, Am Surg 64 (1998) (7), pp. 654–658.

33 M. Catarci, S. Mancini and P. Gentileschi et al., Antibiotic prophylaxis in elective laparoscopic cholecystectomy. Lack of need or lack of evidence?, Surg Endosc 18 (2004) (4), pp. 638–641. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (12)

34 E.J. Lu, M.J. Curet and Y.Y. El Sayed et al., Medical versus surgical management of biliary tract disease in pregnancy, Am J Surg 188 (2004) (6), pp. 755–759. Article | 35 S.G. Swisher, P.J. Schmit and K.K. Hunt et al., Biliary disease during pregnancy, Am J Surg 168 (1994) (6), pp. 576–579.

36 R.E. Glasgow, B.C. Visser and H.W. Harris et al., Changing management of gallstone disease during pregnancy, Surg Endosc 12 (1998) (3), pp. 241–246. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (46)

37 M.D. Rollins, K.J. Chan and R.R. Price, Laparoscopy for appendicitis and cholelithiasis during pregnancy: a new standard of care, Surg Endosc 18 (2004) (2), pp. 237–241. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (33)

*38 D.J. Deziel, K.W. Millikan and S.G. Economou et al., Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases, Am J Surg 165 (1993) (1), pp. 9–14. Abstract | View Record in Scopus | Cited By in Scopus (600)

39 K. Z'graggen, H. Wehrli and A. Metzger et al., Complications of laparoscopic cholecystectomy in Switzerland. A prospective 3-year study of 10,174 patients. Swiss Association of Laparoscopic and Thoracoscopic Surgery, Surg Endosc 12 (1998) (11), pp. 1303–1310. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (87)

40 M. Hashizume and K. Sugimachi, Needle and trocar injury during laparoscopic surgery in Japan, Surg Endosc 11 (1997) (12), pp. 1198–1201. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (72)

*41 A prospective analysis of 1518 laparoscopic cholecystectomies. The Southern Surgeons Club, N Engl J Med 324 (1991) (16), pp. 1073–1078.

*42 E. Keus, H.G. Gooszen and I. Tweel van der et al., Laparoscopic, small-incision, or open cholecystectomy for patients with symptomatic cholecystolithiasis, Cochrane Database Syst Rev (2004) (2) [Protocol].

*43 K.F. Schulz, I. Chalmers and R.J. Hayes et al., Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials, JAMA 273 (1995) (5), pp. 408–412. View Record in Scopus | Cited By in Scopus (2023)

44 D. Moher, B. Pham and A. Jones et al., Does quality of reports of randomized trials affect estimates of intervention efficacy reported in meta-analyses?, Lancet 352 (1998) (9128), pp. 609–613. Article | *45 D. Boerma, E.A. Rauws and Y.C. Keulemans et al., Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis, Ann Surg 234 (2001) (6), pp. 750–757. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (66)

46 A.J. McMahon, G. Fullarton and J.N. Baxter et al., Bile duct injury and bile leakage in laparoscopic cholecystectomy, Br J Surg 82 (1995) (3), pp. 307–313. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (106)

47 D.J. Gouma and P.M. Go, Bile duct injury during laparoscopic and conventional cholecystectomy, J Am Coll Surg 178 (1994) (3), pp. 229–233. View Record in Scopus | Cited By in Scopus (95)

48 M.A. Qureshi, P.E. Burke and N.M. Brindley et al., Post-cholecystectomy symptoms after laparoscopic cholecystectomy, Ann R Coll Surg Engl 75 (1993) (5), pp. 349–353. View Record in Scopus | Cited By in Scopus (11)

49 R.G. Wilson and I.M. Macintyre, Symptomatic outcome after laparoscopic cholecystectomy, Br J Surg 80 (1993) (4), pp. 439–441. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (26)

50 G.L. Carlson, M. Rhodes and S. Stock et al., Role of endoscopic retrograde cholangiopancreatography in the investigation of pain after cholecystectomy, Br J Surg 79 (1992) (12), pp. 1342–1345. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (17)

51 A.J. McMahon, S. Ross and J.N. Baxter et al., Symptomatic outcome 1 year after laparoscopic and minilaparotomy cholecystectomy: a randomized trial, Br J Surg 82 (1995) (10), pp. 1378–1382. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (42)

52 J.C. Woodfield, M. Rodgers and J.A. Windsor, Peritoneal gallstones following laparoscopic cholecystectomy: incidence, complications, and management, Surg Endosc 18 (2004) (8), pp. 1200–1207. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (26)

53 N. Graves, D. Walker and R. Raine et al., Cost data for individual patients included in clinical studies: no amount of statistical analysis can compensate for inadequate costing methods, Health Econ 11 (2002) (8), pp. 735–739. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (18)

54 G.C. Vitale, D. Collet and G.M. Larson et al., Interruption of professional and home activity after laparoscopic cholecystectomy among French and American patients, Am J Surg 161 (1991) (3), pp. 396–398. Abstract | View Record in Scopus | Cited By in Scopus (44)

55 J.M. Johanning and J.C. Gruenberg, The changing face of cholecystectomy, Am Surg 64 (1998) (7), pp. 643–647.

*56 J.J. Escarce, Externalities in hospitals and physician adoption of a new surgical technology: an exploratory analysis, J Health Econ 15 (1996) (6), pp. 715–734. Abstract | 57 G.D. Friedman, Natural history of asymptomatic and symptomatic gallstones, Am J Surg 165 (1993) (4), pp. 399–404. Abstract | View Record in Scopus | Cited By in Scopus (92)

58 A.A. Indar and I.J. Beckingham, Acute cholecystitis, BMJ 325 (2002) (7365), pp. 639–643. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (30)

59 R. Reiss and A.A. Deutsch, State of the art in the diagnosis and management of acute cholecystitis, Dig Dis 11 (1993) (1), pp. 55–64. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (12)

60 J. Svanvik, Laparoscopic cholecystectomy for acute cholecystitis, Eur J Surg Suppl 585 (2000), pp. 16–17. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (5)

61 T. Kiviluoto, J. Siren and P. Luukkonen et al., Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis, Lancet 351 (1998) (9099), pp. 321–325. Article | 62 M. Johansson, A. Thune and L. Nelvin et al., Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis, Br J Surg 92 (2005) (1), pp. 44–49. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (47)

63 A. Assalia, D. Kopelman and M. Hashmonai, Emergency minilaparotomy cholecystectomy for acute cholecystitis: prospective randomized trial – implications for the laparoscopic era, World J Surg 21 (1997) (5), pp. 534–539. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (18)

64 H. Lau, C.Y. Lo and N.G. Patil et al., Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: a metaanalysis, Surg Endosc 20 (2006) (1), pp. 82–87. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (40)

65 A. Ghahreman, J.L. McCall and J.A. Windsor, Cholecystostomy: a review of recent experience, Aust NZ J Surg 69 (1999) (12), pp. 837–840. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (10)

66 S. Kitano, T. Matsumoto and M. Aramaki et al., Laparoscopic cholecystectomy for acute cholecystitis, J Hepatobiliary Pancreat Surg 9 (2002) (5), pp. 534–537. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (25)

*67 J.A. Shea, M.J. Healey and J.A. Berlin et al., Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis, Ann Surg 224 (1996) (5), pp. 609–620. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (186)

68 G.C. Huitema, De mini-cholecystectomie: een veilig alternatief?, Chirurgendagen (2001) [Abstract].

69 T. Syrakos, P. Antonitsis and E. Zacharakis et al., Small-incision (mini-laparotomy) versus laparoscopic cholecystectomy: a retrospective study in a university hospital, Langenbecks Arch Surg 389 (2004) (3), pp. 172–177. View Record in Scopus | Cited By in Scopus (17)

70 S.O. Oyogoa, I.K. Komenaka and R. Ilkhani et al., Mini-laparotomy cholecystectomy in the era of laparoscopic cholecystectomy: a community-based hospital perspective, Am Surg 69 (2003) (7), pp. 604–607. View Record in Scopus | Cited By in Scopus (14)

71 A.A. Shalimov, V.M. Kopchak and A.I. Dronov et al., Cholecystectomy by mini-laparotomy access. Retrospective analysis of the 10-year work, Klin Khir 5 (2001), pp. 12–15. View Record in Scopus | Cited By in Scopus (3)

72 A.K. Sharma, H.K. Rangan and R.P. Choubey, Mini-lap cholecystectomy: a viable alternative to laparoscopic cholecystectomy for the third world?, Aust NZ J Surg 68 (1998) (11), pp. 774–777. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (5)

73 R. Daou, Cholecystectomy using a minilaparotomy, Ann Chir 52 (1998) (7), pp. 625–628. View Record in Scopus | Cited By in Scopus (5)

74 A.N. Supe, V.N. Bapat and S.V. Pandya et al., Laparoscopic versus mini-lap cholecystectomy for gallstone disease, Indian J Gastroenterol 15 (1996) (3), pp. 94–96. View Record in Scopus | Cited By in Scopus (9)

75 V. Seenu and M.C. Misra, Mini-lap cholecystectomy – an attractive alternative to conventional cholecystectomy, Trop Gastroenterol 15 (1994) (1), pp. 29–31. View Record in Scopus | Cited By in Scopus (5)

76 M.M. Al Tameem, Minilaparotomy cholecystectomy, J R Coll Surg Edinb 38 (1993) (3), pp. 154–157. View Record in Scopus | Cited By in Scopus (5)

77 J.G. Stage, N.C. Hjortso and J.B. Dahl et al., Minicholecystectomy, Ugeskr Laeger 153 (1991) (46), pp. 3228–3231. View Record in Scopus | Cited By in Scopus (2)

78 C.E. Morton, Cost containment with the use of ‘mini-cholecystectomy’ and intraoperative cholangiography, Am Surg 51 (1985) (3), pp. 168–169. View Record in Scopus | Cited By in Scopus (5)

79 I. Rozsos, J. Ferenczy and R. Schmitz, Micro and mini-cholecystectomies in the 21st century, Orv Hetil 144 (2003) (26), pp. 1291–1297. View Record in Scopus | Cited By in Scopus (3)

80 J. Perissat, Laparoscopic cholecystectomy: the European experience, Am J Surg 165 (1993) (4), pp. 444–449. Abstract | View Record in Scopus | Cited By in Scopus (74)

81 U. Herzog, P. Messmer and M. Sutter et al., Surgical treatment for cholelithiasis, Surg Gynecol Obstet 175 (1992), pp. 238–242. View Record in Scopus | Cited By in Scopus (21)

82 P.A. Clavien, J.R. Sanabria and G. Mentha et al., Recent results of elective open cholecystectomy in a North American and a European center. Comparison of complications and risk factors, Ann Surg 216 (1992), pp. 618–626. View Record in Scopus | Cited By in Scopus (47)

83 L. Morgenstern, L. Wong and G. Berci, Twelve hundred open cholecystectomies before the laparoscopic era. A standard for comparison, Arch Surg 127 (1992), pp. 400–403. View Record in Scopus | Cited By in Scopus (74)

84 T.M. Gilliland and L.W. Traverso, Modern standards for comparison of cholecystectomy with alternative treatments for symptomatic cholelithiasis with emphasis on long-term relief of symptoms, Surg Gynecol Obstet 170 (1990), pp. 39–44. View Record in Scopus | Cited By in Scopus (66)

85 E.L. Hannan, J.F. O'Donnell and H. Kilburn Jr. et al., Investigation of the relationship between volume and mortality for surgical procedures performed in New York State hospitals, JAMA 262 (1989), pp. 503–510. View Record in Scopus | Cited By in Scopus (302)

86 A.K. Rosen, J.M. Geraci and A.S. Ash et al., Postoperative adverse events of common surgical procedures in the Medicare population, Med Care 30 (1992), pp. 753–765. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (31)

87 L.L. Roos, E.S. Fisher and S.M. Sharp et al., Postsurgical mortality in Manitoba and New England, JAMA 263 (1990), pp. 2453–2458. View Record in Scopus | Cited By in Scopus (40)

88 C.K. McSherry, Cholecystectomy: the gold standard, Am J Surg 158 (1989), pp. 174–178. Abstract | View Record in Scopus | Cited By in Scopus (83)

89 J.B. Ganey, P.A. Johnson Jr. and P.E. Prillaman et al., Cholecystectomy: clinical experience with a large series, Am J Surg 151 (1986), pp. 352–357. Abstract | View Record in Scopus | Cited By in Scopus (34)

90 P.M. Go, F. Schol and D.J. Gouma, Laparoscopic cholecystectomy in The Netherlands, Br J Surg 80 (1993), pp. 1180–1183. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (54)

91 K.E. Deveney, The early experience with laparoscopic cholecystectomy in Oregon, Arch Surg 128 (1993), pp. 627–632. View Record in Scopus | Cited By in Scopus (22)

92 D.E. Litwin, M.J. Girotti and E.C. Poulin et al., Laparoscopic cholecystectomy: trans-Canada experience with 2201 cases, Can J Surg 35 (1992), pp. 291–296. View Record in Scopus | Cited By in Scopus (57)

93 B.M. Wolfe, B.N. Gardiner and B.F. Leary et al., Endoscopic cholecystectomy. An analysis of complications, Arch Surg 126 (1991), pp. 1192–1196.

94 A. Cuschieri, F. Dubois and J. Mouiel et al., The European experience with laparoscopic cholecystectomy, Am J Surg 161 (1991), pp. 385–387. Abstract | View Record in Scopus | Cited By in Scopus (376)

95 P. Wilson, T. Leese and W.P. Morgan et al., Elective laparoscopic cholecystectomy for “all-comers”, Lancet 338 (1991), pp. 795–797. Abstract | View Record in Scopus | Cited By in Scopus (20)

96 G.M. Larson, G.C. Vitale and J. Casey et al., Multipractice analysis of laparoscopic cholecystectomy in 1983 patients, Am J Surg 163 (1992), pp. 221–226. Abstract | View Record in Scopus | Cited By in Scopus (117)

97 D.R. Baird, J.P. Wilson and E.M. Mason et al., An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital, Am Surg 58 (1992), pp. 206–210. View Record in Scopus | Cited By in Scopus (49)

98 N.J. Soper and D.L. Dunnegan, Laparoscopic cholecystectomy: experience of a single surgeon, World J Surg 17 (1993), pp. 16–20. Full Text via CrossRef