[Frequency of serious complications following laparoscopic cholecystectomy.]

In the the last decade laparoscopic cholecystectomy has emerged as the prefered method in the treatment of gallbladder stones. It has proved to be safe and has a relatively low rate of complications. However, major bile duct injuries occur more frequently during laparoscopic cholecystectomy when compared to the open procedure. The aim of this study was to examine the types and frequency of complications occurring during the initial period of laparoscopic cholecystectomy (1991-1998) at Landspitali University Hospital with a special emphasis on major bile duct injuries.

A retrospective analysis was performed on patients charts and operative notes of those who underwent laparoscopic cholecystectomy during the years 1991-1998.

1008 consecutive patients were included in the study of which 727 (72%) were females. Bile leak from the cystic duct or the gallbladder bed was the most common complication and occurred in 23 patients (2.3%). Twenty patients (2%) had an intra-abdominal bleeding postoperatively. Seventeen (1.5%) of the patients had retained stones. Four patients (0.4%) developed a haematoma in the gallbladder bed. Two patients (0.2%) had a lesion of a bile duct and three patients (3%) died in the postperative phase. One hundred and six (10.5%) laparoscopic cholecystectomies were converted to an open procedure with the number of conversions highest in the second year (23%) of the procedure but thereafter the conversion rate was between 5 and 10%. Of the operations which required conversion from a laparoscopic procedure to an open one 74 (70%) were operations done urgently or as an emergency.

Laparoscopic cholecystectomy at Landspitali University Hospital is a safe procedure with a low incidence of complications including major biliary injury. These findings are in accordance with results from other similar studies.