LAPAROSCOPIC CHOLECYSTECTOMY - 1203 CASES WITH ULTRASELECTIVE CHOLANGIOGRAPHY

We present our experience at the University of Chile Hospital with 120 3 cases of laparoscopic cholecistectomy between April 1991 and July 19 93. In only 36 patients ultraselective cholangiography was performed. In 88 cases an endoscopic cholangiography was performed prior to surge ry because of suspicion of choledocolithiasis. In 31 of them choledoco lithiasis was demonstrated, and was successfully treated by papilotomy in 30 of them. In 5,8% of cases conversion to open surgery was necess ary: 1,4% in chronic cholecystitis, 13% in acute cholecystitis and 39% in cases with fibrosis and esclerosis of gallblader with or without b iliary digestive fistula. The intraoperative cholangiography has been advocated as a manner to prevent the common duct injury. In spite of t he small number of cases operated on with cholangiography, we haven't seen serious injuries of billiary tract; a carefully disection, as far away as possible of the common duct, is the best way to prevent iatro genic lesions. Postoperative morbidity was present in 15 cases, 8 of t hem required a new operation. Two patients died.