THE MEXICAN EXPERIENCE WITH LAPAROSCOPIC CHOLECYSTECTOMY AND COMMON BILE-DUCT EXPLORATION - A MULTICENTRIC TRIAL

We present here the initial data collected since the first laparoscopi c cholecystectomy (LC) was performed in our country (June 1990). Twent y-one centers were surveyed (2,399 patients). The most frequent indica tion for LC was chronic gallstone disease (76.2%). The female populati on predominated (69.4%). Seven centers always perform the laparoscopic approach. Antibiotic prophylaxis is the rule, and most centers use na sogastric tube and urinary catheterization. Perioperative cholangiogra phy is done selectively. The instrument of choice to dissect the gallb ladder is the electrosurgical hook-knife. General anesthesia is prefer red (97%). The complication rate was 8.87%. Injury to the bile duct an d bowel perforation occurred in 0.25% and common duct stone retention occurred in 0.29% of patients. Mortality rate reached 0.12%. It is our hope that this study will help in defining the situation of LC in dev eloping countries and that it also can serve as a first step in the or ganization of minimally invasive surgery groups in Mexico.