1525 LAPAROSCOPIC CHOLECYSTECTOMIES WITHOUT BILIARY INJURY - A SINGLEINSTITUTIONS EXPERIENCE

Laparoscopic Cholecystectomy (LC) has become the preferred treatment o f gallbladder disease. The indications for LC remain unchanged from th ose for open cholecystectomy (OC). A total of 1525 patients underwent LC at Georgia Baptist Medical Center between December 1989 and Decembe r 1992. The procedure was completed in 1,492 patients (97.8%) and requ ired conversion to OC in 33 patients (2.2%). Selective intraoperative cholangiography was used in 165 patients (10.8%). Overall morbidity wa s 4.06%, and there were four deaths not operatively related, for a 0.2 6% mortality rate. There have been no biliary ductal injuries. The ave rage hospital stay was 0.82 days, with 37.4% of the patients going hom e as true outpatients and 44.5% going home on postop Day one. Most pub lished series on LC report a small incidence of biliary injury. We fee l that with meticulous dissection of the cystic duct and use of select ive intraoperative cholangiography to define unsure anatomy, biliary i njury can be minimized.