[Laparoscopic laser cholecystectomy: a prospective analysis of 70 initial cases]

Laparoscopic cholecystectomy using Nd-YAG laser was performed in 70 consecutive patients with preoperatively symptomatic gallstones. Sixty-eight patients had successful completion of the laparoscopic cholecystectomy. Mean hospital stay was 7.8 days (range: 4-12), and a diet as well as physical walking was tolerated in all 68 patients by the next day following the procedure. Mean operating time was 216 minutes in the initial 10 cases, which improved significantly to 87 minutes in the latest 28 cases. The difference of operative time did not influence any difference on the postoperative course. Nineteen of 68 patients (27.9%) required postoperative pain medication (pentazocine 15 mg, i.m.). Two patients required conversion to open cholecystectomy because of a pin hole injury on the portal vein by laser quartz in the first case, and difficult dissection due to severe adhesion in the 46th case. There is a definite learning curve in this new modality. Laparoscopic cholecystectomy is a safe and effective procedure, significantly improving the quality of life of the patients with gallstones.