NEW TRENDS IN LAPAROSCOPIC BILIARY SURGER Y

On the basis of the experience gained in 893 laparoscopic procedures p erformed on the gallbladder, and with increasing frequency on the bile -ducts, and on the basis of a comprehensive review of the literature f rom 1992 and 1993 pertaining to this subject, a critical analysis of l aparoscopic gallbladder surgery has been accomplished. As substantiate d by recent publications, laparoscopic cholecystectomy has achieved wi de acceptance in surgical practice. Over the course of the last two ye ars, discussion has focussed on the avoidance of injury caused by Vere ss needle and trocar puncture and specific pneumoperitoneum-associated complications, as well as the minimisation of overlooked and/or spill ed bile-duct calculi and the avoidance of iatrogenic bile-duct injurie s. Procedures to be taken in order to achieve the necessary improvemen t in laparoscopic cholecystectomy are described.