LAPAROSCOPIC CHOLECYSTECTOMY IN A COMMUNITY-HOSPITAL - EXPERIENCE WITH 600 LAPAROSCOPIC CHOLECYSTECTOMIES

We reviewed 600 patients who underwent laparoscopic cholecystectomy (L C) in a teaching community hospital from May 1990 to August 1992. The safety, efficacy, morbidity, and mortality of LC, as performed by one surgeon or under his direct supervision, were studied. Five hundred fo rty-eight patients (91.3%) were treated electively; 52 (8.7%) were adm itted for acute cholecystitis (41) or gallstone pancreatitis (11). Mea n operating time was 54 min, with a range of 20 to 145 min. Twenty-fou r (4%) patients required conversion to traditional (open) cholecystect omy. Operative cholangiograms were completed in 106 patients, These re vealed choledocholithiasis in 7. Five hundred thirty-seven patients (8 9.5%) were discharged within 24 h and 564 (94%) within 48 h. The overa ll morbidity of 9.2% compared favorably with both open and laparoscopi c series previously reported. Three patients (0.5%) had small lacerati ons of the anterior wall of the common duct. Two were recognized and r epaired immediately. The third patient came for treatment on the fifth postoperative day and was stented by a T-tube. There was 1 death in t his group-a myocardial infarction on postoperative day 4.