[Safety of laparoscopic cholecystectomy in complicated vesicular disease]

We assessed the experience and safety of cholecystectomy through laparoscopic approach in patients with complicated biliary gallbladder disease who were attended at the Hospital Español, Veracruz, Mexico, during a 10-year period.

A prospective, longitudinal, comparative study with a control group was designed. We studied a group of patients with complicated cholelithiasis disease (Group I) and compared them with patients without complicated diseases. We analyzed the following variables: age, gender, risk factors, associated trans-operative pathology and accidents, surgical time, rate of conversion to open procedure, length of hospital stay, complications and evolution.

During the 10-year period, 733 cholecystectomies were performed, 245 (33.42%) to treat complicated cholelithiasis and 488 (66.58%) uncomplicated. There were no differences regarding gender, age, risk factors, hospital stay, complications, morbidity and mortality, and iatrogenic lesions of the biliary tree, postoperative morbidity and mortality. In all patients of Group I (245), we found complications of cholelithiasis (acute cholecystitis, choledochal gallstones, vesicular adherences, and cholecystocolonic fistula). Surgical time was longer in Group I and surgical accidents made the surgical procedure more difficult.

The overall results established that laparoscopic cholecystectomy in our institution is a safe procedure in patients with complicated gallbladder disease and can be performed by experienced surgeons.