Özet:

OBJECTIVE: Among many factors affecting the duration of operation, conversion to open, and complication frequency in laparoscopic cholecystectomy, characteristics of patient and experience of the surgeon can be suggested initially. Moreover such factors as operating room equipments, and team features could be effective. The aim of this study is to define the effects of these factors in laparoscopic cholecystectomy. MATERIALS and METHODS: Laparoscopic cholecystectomies were performed by the same experienced surgeons in different health centers. These centers were different from each other in the characteristics of the operating rooms and the team features. The first center was more disadvantaged than the second. Therefore two groups were defined. The frequency of conversion to open and complication, and duration of the operation were compared. RESULTS: There were 427 patients analyzed. Mean age was about 46 years in two periods. The frequencies of female gender, laparoscopic cholecystectomy, and acute cholecystitis were significantly high in the second period. Among the patients in whom laparoscopic cholecystectomy were performed, the frequency of acute cholecystitis increased from 3% to 27% in the second period. However, the frequency of conversion to open decreased from 10.8% to 2.1% and the duration of the operation (median from 102 minutes to 50 minutes) shortened in the second period. Complication frequency did not show difference among the groups (1%). CONCLUSION: Apart from the factors related to the patient and independent from the surgeon's experience, factors as better operating room equipments and team features decrease the frequency of conversion to open and shorten the duration of operation in laparoscopic cholecystectomy.

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