LAPAROSCOPIC CHOLECYSTECTOMY IN 1994 - RESULTS OF A PROSPECTIVE SURVEY CONDUCTED BY SFCERO ON 4,624 CASES

Background: In 1996, laparoscopic cholecystectomy is the gold standard for symptomatic cholelithiasis. The results of this operation as publ ished so far include data on the learning curve of the method, The aim of this study is to evaluate the results of laparoscopic cholecystect omy when performed by a large number of surgeons during the year 1994, not taking into account the beginning years in which the technique wa s being used. Methods: This study has been carried out prospectively a nd anonymously among members of SFCERO. All the patients who underwent a cholecystectomy started laparoscopically during 1994 have been incl uded. Results: Some 4,624 cholecystectomies were performed by 150 surg eons. There were 3,310 females (42.5 +/- 19.8 years old) and 1,314 mal es (56.3 +/- 1.61 years old). The conversion rate was 6.9% : 320 opera tions had to be converted into laparotomy (group II) while 4,261 were performed entirely by laparoscopy (group I). Morbidity was 5% (N = 230 )-4.7% in group I (N = 203) and 8.4% in group II (N = 27). Mortality w as 0.2% (N = 9)-namely four intraabdominal complications (three cases of peritonitis and one biliary reoperation), two cardiac failures, and one brain infarction. The causes of death were not specified in two p atients. Conclusions: These results show that morbidity and mortality have not changed dramatically since the beginnings of this technique, whereas the frequency of common bile duct (CBD) injuries has decreased . However, the conversion rate has increased slightly. These results m ake it possible to calculate the risk of conversion and postoperative complication according to the age of the patient and the biliary sympt oms.