Abstract
ABSTRACT
To compare the quality of cholecystectomy before and after the introduction of laparoscopic technique, a comparison was made between 463 consecutive patients undergoing open cholecystectomy (OC) during 1985–1989 and 329 consecutive patients cholecystectomized during 1991–1993 after the introduction of laparoscopic cholecystectomy (LC) (i.e., open or laparoscopic cholecystectomies). The frequency of procedure-related complications was unchanged in the two periods [13 vs. 9% (NS)], but general complications were reduced from 17 to 9% (p < 0.001), mainly attributable to a reduced incidence of pulmonary complications. Mortality was 2.2 and 0.9%, respectively (NS). The frequency of bile duct injury was 0.2% in the first and 0.6% in the second period (NS). The frequency of reoperations was 2.8 and 1.8% (NS), and residual stones were later detected in 3.0 and 3.6%, respectively (NS). Hospital stay after elective surgery was reduced from 6 days in the first period to 4 days in the second (all cases) (p < 0.001). Thus the quality of cholecystectomy improved regarding general complications, while mortality and number of reoperations were unchanged. Further improvement is desirable to prevent general as well as procedure-related complications.
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