IMPACT OF LAPAROSCOPIC TECHNIQUE ON THE QUALITY OF CHOLECYSTECTOMY

To compare the quality of cholecystectomy before and after the introdu ction of laparoscopic technique, a comparison was made between 463 con secutive patients undergoing open cholecystectomy (OC) during 1985-198 9 and 329 consecutive patients cholecystectomized during 1991-1993 aft er the introduction of laparoscopic cholecystectomy (LC) (i.e., open o r laparoscopic cholecystectomies). The frequency of procedure-related complications was unchanged in the two periods [13 vs. 9% (NS)], but g eneral complications were reduced from 17 to 9% (p < 0.001), mainly at tributable to a reduced incidence of pulmonary complications. Mortalit y was 2.2 and 0.9%, respectively (NS). The frequency of bile duct inju ry was 0.2% in the first and 0.6% in the second period (NS). The frequ ency of reoperations was 2.8 and 1.8% (NS), and residual stones were l ater detected in 3.0 and 3.6%, respectively (NS). Hospital stay after elective surgery was reduced from 6 days in the first period to 4 days in the second (all cases) (p < 0.001). Thus the quality of cholecyste ctomy improved regarding general complications, while mortality and nu mber of reoperations were unchanged. Further improvement is desirable to prevent general as well as procedure-related complications.