LAPAROSCOPIC CHOLECYSTECTOMY - SITUATION REPORT

Since its introduction a few years ago, laparoscopic cholecystectomy h as become today the standard treatment of gallbladder stones. Compared to open surgery it involves little change in the preoperative investi gations. There has been, especially in the beginning of the learning c urve, a demand for preoperative visualization of the bile duct anatomy and for exclusion of intraductal stones. Thus the incidence of preope rative ERCP has risen with the development of laparoscopic cholecystec tomy. For the advanced laparoscopic surgeon, the indications for lapar oscopic cholecystectomy are the same as for open surgery. The benefits of laparoscopy for the patient are obvious and the results are favour able. Bile duct injury is a very severe complication and, at the begin ning of the learning curve, the incidence has been somewhat higher tha n in open surgery. Therefore, proper training in laparoscopic surgery and quality control are necessary. Many reports on advanced laparoscop ic procedures have already been published, but only the future will sh ow the limits of this technique.