[A trial of evaluation of cholecystectomy by celioscopic approach. Apropos of 2266 patients]

Facing enthusiasm and critics it is necessary to evaluate new surgical techniques. The aim of our study is to try to evaluate cholecystectomy by laparoscopy. 2266 patients operated on by laparoscopy in France are compared with 3390 patients operated on by laparotomy which were published in 1990 in American surgical revues. Both groups are comparable concerning age of patients and surgical indications. Even if 10% of the patients operated on by laparoscopy needed a laparotomy, the morbidity and the mortality were not significantly different in both techniques. This study allows to conclude that cholecystectomy done by laparoscopy offers the same security to patients than using laparotomy, with in addition a faster and better recovery and a much lower economic cost. However, some problems are not yet resolved, especially the one concerning main bile duct stones and the one concerning the necessity of a special training for these surgical laparoscopic technics.