Abstract:

Purpose: The aim of this study is to evaluate the first 416 cases of laparoscopic cholecystectomy (LC) performed in the General Surgery Department of Adnan Menderes University Medical School. Patients and Methods: The data obtained from the LC cases between August 1997 and January 2001 were analysed retrospectively. Results: The sex distribution of the cases was 335 (80.5 %)femaleand81 (19.5 %)male (F/M: 4.1). Medianage was 51.2 years (range: 18-82), median operative time was 79.2 minutes (range: 17-330). Indications for surgery were chronic cholecystitis in 393 (94.5 %), acute cholecystitis in16 (3.8 %), andgallbladderpolyps in7 (1.7 %). History ofupperabdominal surgery was present in 9 (2.2 %) and lower abdominal surgery in 37 (8.9 %) patients. Overall, conversion to open laparotomy was necessary in 15 patients due to (adhesions in 3, bleeding in 2, biliary duct injury in 2 and malignancy in 1) and intraoperative complications occured in 53 (12.7 %) patients (37 gall bladder perforation, 10 bleeding, 3 biliary duct injury, 1 intestinal perforation and 3 technical problems). Four patients (1 %) required reoperation due to complications (bleeding in 2, biliary duct injury in 1 and intestinal injury in 1). Overall morbidity rate was 14.9 % and there was no mortality. Median postoperative hospital stay was 1.6 days (8 hours-28 days). Conclusion: LC was applied to all patients who had cholelithiasis in our clinic. Acute cholecystitis seems to be the main factor increasing the ratio of conversion to open cholecystectomy. However, LC should be the first choice for all cases with cholelithiasis.

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