Laparoscopic cholecystectomy: morbidity and mortality in a community teaching institution

From November 1989 to December 1990, 474 elective laparoscopic cholecystectomies were performed. This study analyzes the first year's experience with regard to complications, postoperative response in terms of pain and nausea, and time back to activity and work. There were 369 females and 105 males in the group. The average age was 51.5 years. Of these, 394 were discharged within 23 h and 80 required admission postoperatively. Of the group requiring hospitalization, there were 10 (2.1%) major complications, 37 (7.8%) minor complications, 14 (3.0%) aborted laparoscopic cholecystectomies, and 19 (4.0%) others. Major complications occurred early in the surgeon's experience, all but two within the surgeons' first 25 cases. Patients in the short stay group were followed-up with a phone questionnaire. In this group, most patients experienced minimal abdominal pain following surgery, with an average score of 2.4 (SD = 1.38) on a scale of 1 (absent) to 5 (extreme). At home, 48.6% of patients experienced some form of postoperative discomfort. Of these, 38.2% experienced abdominal pain, 18.7% shoulder pain, and 32.7% nausea. The average postoperative time to resume normal daily activity was 7.9 days (SD = 8.2) and to return to work was 11.6 days (SD = 9.9).