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Laparoscopic cholecystectomy in The Netherlands
The British Journal of Surgery
|September 1, 1993
Summary
Laparoscopic cholecystectomy rapidly gained acceptance in the Netherlands. This study evaluated its safety and efficacy, finding results comparable to conventional methods despite a notable rate of bile duct injuries.
Area of Science:
- Surgical Innovation
- Gastrointestinal Surgery
- Minimally Invasive Procedures
Background:
- Laparoscopic cholecystectomy (LC) was introduced in the Netherlands in 1990.
- General surgical practice adoption of LC required safety and efficacy evaluation.
- Early insights into LC's performance in a national setting were needed.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic cholecystectomy in Dutch hospitals during its initial two years.
- To assess complication rates, including mortality and bile duct injuries.
- To gather surgeons' opinions on contraindications and patient eligibility for LC.
Main Methods:
- A nationwide survey was conducted using questionnaires sent to 138 surgical institutions.
- Data collected included conversion rates, complications, operating times, and hospital stays for 6076 LC procedures.
- Surgeons' perspectives on contraindications and patient selection criteria were also recorded.
Main Results:
- A 100% response rate yielded data on 6076 LCs.
- Conversion to open surgery occurred in 6.8% of cases; 4.3% experienced postoperative complications.
- Seven deaths (0.12%) and 52 bile duct injuries (0.86%) were reported. Mean operating time was 70 minutes, mean hospital stay 4.5 days.
Conclusions:
- Laparoscopic cholecystectomy achieved rapid adoption in the Netherlands.
- Despite a high rate of bile duct injuries, overall results were comparable to specialized centers and conventional cholecystectomy.
- Surgeons' views indicated a high patient eligibility for LC, with specific contraindications addressed.