LAPAROSCOPIC CHOLECYSTECTOMY - 700 CONSECUTIVE CASES

From March 1993 till June 1995 700 laparoscopic cholecystectomies have been performed on 590 female and 110 male patients who ranged from 10 to 82 years of age at the Departments of Surgery of County Hospital a nd Alexander's University Hospital in Sofia, Ninety seven of the patie nts (13.8%) who have had laparoscopic cholecystectomies (LC) were diag nosed as acute cholecystitis and the rest as chronic calculous cholecy stitis, In 16 cases (2.28%) a conversion to standard open cholecystect omy was necessary, the most frequent causes being intraoperative bleed ing and unsuspected preoperatively common bile duct stones, Immediate or early postoperative laparotomy was performed in four cases because of biloma (1), small intestine strangulation in the umbilical region ( 1), perforated duodenal ulcer (1), bleeding (1). One case required lap arotomy and removal of a clip misplaced tangentially to the right hepa tic duct, There were no cases with lethal outcome following LC. Sixtyf ive patients have had intraoperative cholangiography and 14 patients u nderwent concomitant laparoscopic choledochotomy and common bile duct stones extraction.