Laparoscopic cholecystectomy: an Indian experience of 1233 cases.

BACKGROUND Laparoscopic cholecystectomy (LC) is a well-established procedure for symptomatic cholelithiasis in India, but there are few data available regarding the procedure and its related complications. PATIENTS AND METHODS This paper represents a retrospective review of 1233 patients who underwent LC at Government Medical College and Hospital, Chandigarh, India, over 4 years (1997-2000). The case files of all these patients were analyzed for patient particulars, intraoperative findings, reason for any open conversion, postoperative stay, and mortality. RESULTS The overall conversion rate was 7.06% (87 patients). The commonest cause of conversion was a frozen Calot's triangle (52 patients), followed by injury to the common bile duct (8 patients). The average postoperative stay in successful LC was 1.32 days. The overall mortality rate was 0.16% (2 deaths). The quality of life after LC was good to excellent in more than 90% of patients. CONCLUSIONS Despite multiple hands in training, the complication rates of LC are within acceptable limits. The overall conversion rate has risen because of the increase in elective conversions, but the incidence of complications has come down because of a "no hesitation" policy in converting. In spite of multiple operators, LC is the procedure of choice for symptomatic cholelithiasis at our hospital.

[1]  D. Flum,et al.  Should cholecystectomy be performed for asymptomatic cholelithiasis in transplant patients? , 2003, Journal of the American College of Surgeons.

[2]  M. Cheung,et al.  Audit of laparoscopic cholecystectomy in a single center. , 1999, Surgical laparoscopy, endoscopy & percutaneous techniques.

[3]  G. Fullarton,et al.  Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. , 1996 .

[4]  G. Fullarton,et al.  Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: An audit of 5913 cases , 1996, The British journal of surgery.

[5]  G. Mathew,et al.  Impact of laparoscopic cholecystectomy in a major teaching hospital: clinical and hospital outcomes , 1995, The Medical journal of Australia.

[6]  G. Berci,et al.  Continuing hazards of the learning curve in laparoscopic cholecystectomy. , 1995, The American surgeon.

[7]  R. Steele,et al.  Introduction of laparoscopic cholecystectomy in a large teaching hospital: Independent audit of the first 3 years , 1995, The British journal of surgery.

[8]  P. O’Dwyer,et al.  Bile duct injury and bile leakage in laparoscopic cholecystectomy , 1995, The British journal of surgery.

[9]  G. Ramsay,et al.  Laparoscopic versus minilaparotomy cholecystectomy: a randomised trial , 1994, The Lancet.

[10]  D. Gouma,et al.  Laparoscopic cholecystectomy in the Netherlands , 1993, The British journal of surgery.

[11]  Y. Yamashita,et al.  Laparoscopic cholecystectomy: the Japanese experience. , 1993, Surgical laparoscopy & endoscopy.

[12]  D. Brooks,et al.  Bile duct disruption and biloma after laparoscopic cholecystectomy: imaging evaluation. , 1992, AJR. American journal of roentgenology.

[13]  Blumgart Lh,et al.  A technique for the construction of high biliary-enteric anastomoses. , 1982 .