CONVERSIONS AND COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY - RESULTS OF A SURVEY CONDUCTED BY THE FRENCH-SOCIETY-OF-ENDOSCOPIC-SURGERY-AND- INTERVENTIONAL-RADIOLOGY

During 1991, 41 surgeons of the French Society of Endoscopic Surgery a nd Operative Radiology (SFCERO) performed 3,673 cholecystectome of whi ch 2,955 were laparoscopic. Data for those patients in whom a conversi on to laparotomy was necessary or a complication occurred were collect ed by a retrospective multicenter survey. Conversion was performed in 142 patients (4.8%): in 106 this was due to pathology in the subhepati c space; in 36 it was because of a complication related to the laparos copy. There were 101 postoperative complications (morbidity 3.4%): 59 biliary and 42 non biliary complications and six deaths (mortality 0.2 %). There were 18 bile duct injuries, one of which led to the death of the patient. Excluding conversions to laparotomy, these figures are c omparable to those for open cholecystectomy. These results define the limits and advantages of laparoscopic cholecytectomy. Conversion to la parotomy remains a wise option in cases of technical difficulty or dou btful biliary anatomy.