[Laparoscopic cholecystectomies. First 100 attempted cases at Reykjavik City Hospital]

An account is given of the first 100 attempted laparoscopic cholecystectomies at Borgarspitalinn, Reykjavik City Hospital. The mean age of the patients was 48.7 years with a range of 17-86 years. Seventy seven of the patients were women and 23 men. Ten patients (10%) had acute cholecystitis but others had uncomplicated cholelithiasis. In 10 patients the operation was converted to conventional open cholecystectomy, in most cases because of acute inflammation or adhesions from previous surgery but in one case because of haemorrhage. Five patients had complications, all of which can be considered minor. There was no common bile duct injury and no mortality. No patient required reoperation. The mean operative time for the laparoscopic cholecystectomies was 102 minutes (range 50-222 minutes) and 75% of the operations were completed within two hours. The mean operative time for the first 30 laparoscopic cholecystectomies was 109.7 minutes and dropped to 94.3 minutes for the last 30. The operative time has continued to decrease with further experience. Fifty four percent of the patients who underwent laparoscopic cholecystectomies were discharged from hospital on the first postoperative day and a further 32% on the 2nd day after surgery. The hospital stay was on average four days shorter than after the conventional open cholecystectomies performed in the last months prior to commencing laparoscopic surgery. Eighty three percent of the patients were back to work or previous activity within two weeks of surgery compared to only 11.4% of patients who had undergone open cholecystectomies. Laparoscopic cholecystectomy is felt to be a safe procedure and highly cost-effective.