Laparoscopic cholecystectomy: the Japanese experience

We investigated the current status of laparoscopic cholecystectomy in Japan. A retrospective survey of laparoscopic cholecystectomy was performed involving 1989 patients from eight Japanese institutions. The preoperative work-up and the operative technique were largely identical to those in the United States. Conversion to open cholecystectomy was required in 54 patients (2.7%) because of unexpected intraoperative findings such as inflammation and adhesions in 40 patients (2.0%) and intraoperative complications in 14 patients (0.7%). There were no deaths, and postoperative complications occurred in 34 of 1935 patients (1.75%) in whom laparoscopic cholecystectomy was completed. Only 10 patients (0.51%) had serious complications (hemorrhage and bile duct injury, for example) that required laparotomy. The incidence of bile duct injury was 11 of 1989 (0.55%). We conclude that the adoption of laparoscopic cholecystectomy in Japan has been highly successful.