Brunei has a small population and a unique medical setup: The number o
f laparoscopic cholecystectomies (LCs) performed in our institution re
presents the total number of cases performed in this country. A prospe
ctive analysis of all the LCs performed in Brunei is presented. All 22
0 LCs performed between February 1, 1992, and November 30, 1996, were
prospectively recorded on a detailed protocol. Analyses were made with
respect to preoperative patient demography, intraoperative complicati
ons, and postoperative morbidity and mortality. Symptomatic gallstone
disease was found to be common among the ethnic Nepalese population. I
n this series, nine patients required conversion to open surgery (4%).
Acute cholecystitis comprised 21% of cases, and the mean operating ti
me was longer in these cases (144.1 min) than in elective cases (101.2
min; P = 0.002). The overall morbidity was 5% with one ductal injury
(0.5%). The mortality rate in this series was 0.5%. Our results of LC
are favorable and comparable with those of published series. We conclu
de that LC has been successfully introduced into our institution. This
study also represents an unofficial audit of the state of development
of LC in Brunei.