Laparoscopic cholecystectomy: An analysis on 114,005 cases of United States series

114,005 cases from 40 United States series of laparoscopic cholecystectomie s (LC) were reviewed. Indications, conversion rates, rates of intra-operati ve cholangiography (IOC), and incidence of bile duct stone and iatrogenic b ile duct injuries were assessed. Indications included acute cholecystitis i n 11.6% and gallstone pancreatitis in 2.1% of reported cases. Conversion ra te was to be primarily related to inflammation. Unsuspected bile duct stone s were detected intra-operatively in 7.8% of cases. 561 major bile duct inj uries (BDI) and 401 bile leaks (BL) were recorded and acute or chronic infl ammation was their most important potential predisposing factor, In series with a high rate of IOC performed during LC, BDJ and BL were slightly lower and lesions recognized intra-operatively were much higher than in series w ith low rate of IOC. BDJ occurred in the first 50 patients of the surgeon's experience in about 91% of the cases.