[Laparoscopic cholecystectomy--late results]

From September 1985 to March 1987 I carried out the first 94 laparoscopic cholecystectomies, with pneumoperitoneum, in the world. Later I preferred the better open laparoscopic cholecystectomy without pneumoperitoneum. In the same period I treated 136 patients with simple cholecystectomy by laparotomy. Five years 2% of the endoscopically operated patients mentioned slight pain in the scar, while 12% of the laparatomy group had scar problems, including four patients with hernias (p = 0.0084). One patient in the endoscopy group had complications from the biliary system because of a common duct calculus. Intraoperative cholangiography is needed to prevent residual stones and biliary lesions. The indications for the endoscopic procedure should be extended in view of the reduced operative risk and the trend to increasingly longer spontaneous courses.