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Elective laparoscopic cholecystectomy for "all-comers".

P Wilson¹, T Leese, W P Morgan

¹Department of Surgery, Royal Lancaster Infirmary, UK.

Lancet (London, England)

|September 28, 1991

Summary

Laparoscopic cholecystectomy is a safe and effective gallbladder removal surgery. This study shows it is also cost-effective for general surgeons in district hospitals.

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Area of Science:

General Surgery
Minimally Invasive Procedures

Background:

Laparoscopic cholecystectomy (LC) offers benefits but requires specialized skills.
Wider adoption necessitates general surgeon proficiency in LC.

Purpose of the Study:

To evaluate the safety and efficacy of LC in a district general hospital setting.
To assess the feasibility of LC for general surgeons outside specialist centers.

Main Methods:

Prospective study of 180 patients undergoing elective LC over nine months.
All eligible patients for open cholecystectomy were offered the laparoscopic approach.
Data collected on operative time, conversion rates, morbidity, mortality, and recovery.

Main Results:

LC was successfully completed in 94% of patients; 6% required conversion to open surgery.

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Median operative time was 55 minutes.

Low serious morbidity (2%) and no mortality; 3 patients needed treatment for retained stones.

90% of patients discharged within 48 hours, with a median 12-day recovery to full activity.

Conclusions:

Laparoscopic cholecystectomy is a safe and effective procedure for district general hospitals.
General surgeons can achieve good outcomes with this technique, demonstrating cost-effectiveness.