1, 000 Cases of Laparoscopic Cholecystectomy by a Single Surgeon

Park, Geun Jun; Shin, Jun Ho

Abstract

PURPOSE
A Laparoscopic cholecystectomy has been the treatment of choice for acute and chronic disease of the gallbladder. We have performed about 1, 500 cases of laparoscopic cholecystectomy since 1991. The purpose of this study is to analyse 1, 000 cases of laparoscopic cholecystectomy performed by a single surgeon and observe the effectiveness of this form of treatment of for gallbladder disease. METHODS: From March 1993 to December 2001, 1, 000 patients underwent a laparoscopic cholecystectomy at our department by a single surgeon. They were divided into 2 groups; group 1 being those of the first half of the period and group 2 being those of second half. We reviewed the patient's charts, age, sex, associated medical diseases, final diagnosis, operation time, occurrence of conversion from laparoscopic to open cholecystectomy, surgical complication and hospital stay. RESULTS: The mean age was 51.2+/-2.37 years and the male-to-female ratio was 1: 1.3. There was no difference of age or sex between two groups. Nineteen percent from group 1 and 16.6% from group 2 had a history of previous abdominal surgery. 22.2% from group 1 and 28.6% from group 2 had a associated disease. Chronic cholecystitis was the most common final diagnosis in both groups. But while the incidence of acute cholecystitis of group 1 was 7%, that of group 2 was 20.6%, which significantly increased (P<0.05). The mean operation time was 69.4 and 45.2 minutes, the conversion rate was 3.8% and 1.2% (P<0.05). The surgical complication rate was 4.4% and 2.4%, and the length of hospital stay was 4.7 and 3.9 days in groups 1 and 2, respectively
Conclusion
Laparoscopic cholecystectomy is a safe and effective treatment for gallbladder diseases. As surgical experience incerased with a rising number of cases, the conversion rate, complication rate and hospital stay decreased. However, the rate of acute cholecystitis increased. For this result, we think that an excellent skill and significant experience of surgeon is essential for this results.