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Abstract
Laparoscopic cholecystectomy is a minimally invasive procedure whereby the gallbladder
is removed using laparoscopic techniques. The indications are similar to those for
elective traditional cholecystectomy, but selection of patients is important for success.
Contraindications are currently evolving. Patients with advanced cholecystitis, abdominal
sepsis, ileus, bleeding disorders, pregnancy, and morbid obesity should not undergo
this procedure. The procedure requires good traditional surgical skills, as well as
additional laparoscopic (and laser) skills. Operative time is slightly longer than
for traditional cholecystectomy, but decreases with experience. Morbidity is low,
but there is a concern about bile duct injuries. Mortality is very low (0%) and is
comparable to traditional cholecystectomy (0.4%). The major advantages of laparoscopic
cholecystectomy are the short hospital stay (average: 2 days) and early return to
normal activity (7 days). This results in a reduction in hospital costs. Adequate
training and credentialing are important processes to foster good patient outcomes.
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References
- Laparoscopic laser cholecystectomy. A comparison with mini-lap cholecystectomy.Surg Endosc. 1989; 3: 131-133
- Laparoscopic guided cholecystectomy.Am J Surg. 1991; 161: 36-44
Fitzgibbons RJ, Jr, Schmid S, Santoscoy R, et al. Laparoscopic cholecystectomy: the beginning of a new era in general surgery. (Submitted for publication)
- Safety and efficacy of laparoscopic cholecystectomy; a prospective analysis of 100 initial patients.Ann Surg. 1991; (in press)
- Laparoscopic cholecystectomy.Surg Clin North Am. 1990; 70: 1249-1262
- Cholecystectomy: the gold standard.Am J Surg. 1989; 158: 174-178
Article info
Footnotes
☆Presented as part of a postgraduate course on interventional laparoscopy during the American College of Surgeons 1990 Clinical Congress, San Francisco, California, October 12, 1990.
Identification
Copyright
© 1991 Published by Elsevier Inc.
