[Cholecystectomy by laparoscopy. Operative technic. Results of the first 100 cases]

The authors describe their own technique for the treatment of gallbladder stones using a laparoscopic approach. They squeletonsie the cystic artery and duct. Their clamp them by clips. Next they introduce into the gallbladder an ultrasonic lithotriptor which fragments the stones into powder evacuated by aspiration. The empty and clear gallbladder is severed off the liver and extracted out of the abdomen through an 8 mm orifice formerly used for the introduction of the lithotriptor. Among the 104 first cases performed between November 1988 to December 1989 the mortality is zero. On three patients the laparoscopic procedure has had to be stopped and replaced by a traditional open cholecystectomy. 3 complications occurred postoperatively: 1 biliary fistula which cured spontaneously within 7 days and 2 intra abdominal abscess which were treated by a secondary laparoscopic drainage. In the other cases the postoperative time has been uneventful. The patients appreciate mostly the painless postoperative time the absence of skin scar the short hospital stay 4 days and the possibility to go working one week later.