Laparoscopic cholecystectomy: experience with 303 patients over the initial four years

A total of 303 patients underwent attempted laparoscopic cholecystectomy (L C) over a four-year period by two consultant surgeons or a senior trainee u nder their supervision. The: procedure was completed in 291 with a conversi on rate to open cholecystectomy of 3,9% and a median postoperative length o f stay of two days, range zero to nine days. In eighteen patients the indic ation for LC was failure of symptoms to settle, two of whom required conver sion (11,1%), Diathermy dissection was avoided in Calot's triangle and diss ection started at the junction of Hartmann's pouch and cystic duct with ful l mobilisation of this area prior to clip application, Pre-operative endosc opic retrograde cholangiopancreatography ERCP was performed in patients sus pected of having common bile duet stones without routine intra-operative ch olangiography, There was one death in this series (0.3%) and an overall com plication rate of 6.3%, There was no incidence of either bile duct injury o r leak, LC can be performed with a low complication rate with attention to careful dissection technique in the region of Calot's triangle.