COMPLICATIONS AFTER LAPAROSCOPIC CHOLECYSTECTOMY

After becoming alarmed about seven unusual and severe complications re ported by New York State hospitals after laparoscopic cholecystectomy, the Department of Health of New York State tabulated all reported adv erse incidents. After observing unusual injuries to the great vessels of the abdomen and an increase in major bile duct injury during laparo scopic cholecystectomy, the Department of Health prepared a memorandum to New York State hospitals advising closer attention to education, c redentialing, proctoring, and outcome after these operations. The freq uency of cholecystectomy has increased sharply, by 21%, since the adve nt of laparoscopic cholecystectomy. The serious injury rate may be app roximately 15 times that observed after an open cholecystectomy. Recog nizing the theoretic advantages of the procedure, the Department of He alth reminded hospital Boards of Trustees of their obligation to estab lish mechanisms for credentials and privileging surgeons and surgical teams so that the risks do not exceed those expected of the open proce dure and to detect and correct deviations from this standard.