LAPAROSCOPIC CHOLECYSTECTOMY INTRAOPERATIVE FINDINGS AND POSTOPERATIVE COMPLICATIONS

From November 1990 to April 1994 we attempted laparoscopic cholecystec tomy (LC) in 1,788 consecutive patients. The intraoperative findings r elated to gallbladder's pathology were as following: chronic cholecyst itis in 792 patients (44.3%), simple cholecystolithiasis in 760 (42.5% ), acute cholecystitis in 98 (5.5%), hydrops in 44 (2.5%), empyema in 38 (2.1%), gangrenous cholecystitis in 12 patients, acalculous cholecy stitis in 20 patients, polyps in 11 patients, adenomyomatosis in 9 pat ients, and gallbladder's carcinoma in 4 patients. Although we had a co nsiderable number of cases with severe inflammation and/or dense adhes ions the conversion rate to open surgery was relatively low (2.5%). Th ere was no procedure-related mortality and no common bile duct injury. Postoperative complications occurred in 58 patients (3.2%). Bile leak was present in 19 patients, retained bile duct stones in 8, severe bl eeding in 6, mild pancreatitis in 4, pulmonary embolism in I, cerebral bleeding in 1, wound infection in 6, abdominal wall hematoma in 4, an d umbilical incisional hernia in 2; 7 patients presented other minor c omplications. The mean postoperative hospital stay of our patients was 1.8 days (range 1-12 days). Adequate measures to prevent intraoperati ve accidents, meticulous technique, and full maintenance of the equipm ent are among the most important factors in keeping a -low conversion and complication rate in the patients undergoing LC.