Audit of Laparoscopic Cholecystectomy: 5 years experience in a University Hospital

All patients, who underwent laparoscopic cholecystectomy for cholelithiasis, from September 1998 to September 2003 were retrospectively reviewed. There were 549 patients and out of those, 507 were female and 42 male subjects. The age ranged from 17-71 years for females and 18-69 years for male patients: median age 41.4 years. 476(86.7%) cases presented with chronic cholecystitis, 63(11.4%) acute cholecystitis, 6(1%) mucocele of the gallbladder and 2(0.4%) had empyema of the gallbladder. Sixteen cases were converted to open cholecystectomy (conversion rate of 2.9%) with a success rate of 97% for laparoscopic cholecystectomy. The reasons for conversion were found to be 8(1.4%) difficult dissection, 4(0.7%) bleeding from cystic artery, 2(0.3%) suspected duodenal injury, 1(0.1%) suspected colonic injury and 1(0.1%) Mirizzi`s syndrome. Postoperative hospital stay ranged from 1-13 days (mean 1.23). Atelactasis was reported to be the most frequent complication found in 9(1.6%) patients followed by deep vein thrombosis and subumbilical wound infection noted in 6(1%) cases each (P<0.00). Four patients had common bile duct injury and one case sustained common hepatic duct injury. All these patients had successful Roux-en-Y hepaticojejunostomy. There was no mortality in this series. Laparoscopic cholecystectomy is a safe and feasible procedure and should be the first line of treatment for symptomatic cholelithiasis.