LAPAROSCOPIC CHOLECYSTECTOMY - EXPERIENCE S AT A BRITISH GENERAL-HOSPITAL

In the first year after the introduction of the new technique a compli cation rate of 3.3 % was calculated from the evaluation of 118 laparos copic cholecystectomies. The only severe complication noted was a perf oration of the transverse colon following the insertion of a 10 mm por t. Henceforth, open laparoscopy is performed in difficult cases. Hereb y, to ensure a more secure sealing of the initial incision, an endotra cheal tube can be used as the camera port. The conversion rate was fou nd to be 9 %, whereby in 50 % of acute cholecystitis an open procedure had to be adopted. The use of a Nd-Yag-Laser in 24 cases proved to be of no apparent advantage intraoperative cholangiograms were carried o ut selectively to demonstrate the anatomical situation. or in cases wh ere common bile duct stones were suspected. Within a year. it was poss ible to reduce the mean operating time from 130 min to 80 min. The pos toperative stay was on average 3.7 days. From an economic point of vie w, the substantially shorter hospitalisation period outweighs the long er operating time. However, more stringent and precise standards with respect to an overall concept in diagnosing and treating common bile d uct stones would be beneficial.