[Laparoscopic and standard cholecystectomy: comparison of immediate results]

The advantages of laparoscopic cholecystectomy (LChE) are undoubtable in comparison with traditional one. However the experience showed, that LChE is not devoid of some shortcomings. It is characterized by the same typical complications as in ChE, besides it may be followed by some specific complications. The literature concerning the rate of complications in LChE are controversial. The comparative analysis has been carried out concerning the rate of complications after ChE (6800 operations) and LchE (900). The mean age of patients with choledocholythiasis--61.4 years. 40% of the patients had severe accompanying diseases coronary artery disease, complicated forms of arrythmia, arterial hypertension, diabetes mellitus, obesity. There were no significant differences between patients who underwent ChE (group 1) and LChE (group 2) by their age and the rate of accompanying diseases. Intraoperative cholangiography was performed in 3.5% of cases of group 1 and in 1.1%--in group 2. The average rate of the operations on extrahepatic bile ducts in group 1 was also lower--choledocholithotomy was carried out in 2.7%, transduodenal papillosphyncterotomy--in 1.7% of cases, drainage of the choledochal duct--in 1.9%. Combined operations were carried out in 10% of patients of group 1 and in 9.1% cases of group 2. The rate of intraoperative bleedings which demanded repeated operations made up in patients of group 1 0.1%, in patients of group 2 0.5%. Intraoperative damage of the choledochal duct in group 1 were detected in 0.14% and in group 2--in 0.11% of cases (the only complication of LChE in a patient was assessed as a endogenous wall clipping).