COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY - THE EXPERIENCE OF A UNIVERSITY-AFFILIATED TEACHING HOSPITAL

Background: In most published reports on laparoscopic cholecystectomy, the cases have been accrued from small community hospitals in a multi center fashion. The purpose of this study was to compare the rate of c omplication following laparoscopic cholecystectomy performed at a sing le university-affiliated teaching hospital to those quoted in the lite rature. Study design: A retrospective review of the first 1300 laparos copic cholecystectomies performed at the Videoscopic Surgery Center at Pennsylvania Hospital from May 1990 through January 1994 was undertak en. Complications were classified as those related to creation of the initial pneumoperitoneum and those related to cholecystectomy. Results : A 3% conversion rate to open cholecystectomy (n = 40) was noted due to the presence of dense adhesions, gangrenous cholecystitis, or diffi cult anatomic relationships. There were 18 complications (1.4%) relate d to creation of the initial pneumoperitoneum and 14 complications (1. 1%) related to cholecystectomy. Complications related to laparoscopy i ncluded bleeding from the abdominal wall (n = 2), trocar site hernia ( n = 11), hollow viscus injury (n = 1), and wound infection (n = 4). Co mplications related to cholecystectomy included unanticipated retained CBD stone (n = 5), symptomatic bile leak (n = 6), hollow viscus injur y (n = 1), intraabdominal abscess (n = 1), and a retained portion of g allbladder (n = 1). There were no perioperative deaths related to lapa roscopic cholecystectomy, and the overall morbidity was 2.4 %. Long-te rm follow-up revealed no cases of benign biliary strictures. Conclusio ns: With attention to anatomy, technique, and meticulous dissection, l aparoscopic cholecystectomy can be safely performed in a university-af filiated teaching hospital setting.