[Laparoscopic cholecystectomy in a medical training center. Apropos of 208 interventions]

Laparoscopic cholecystectomy is a relatively recent acquisition and still remains limited to few surgeons. We started an education program for surgeons used to open biliary surgery. Between september 1990 and december 1991, 208 patients have been operated on by 14 operators flanked by 2 teachers. Technique was standardized and all patients were looked preoperatively for absence of stones in bile ducts using i.v. cholangiography and tomography. Only 6 patients (< 3%) needed to be converted to laparotomy. Morbidity was less than 6% and due to minor complications. Only one patient needed a reoperation because of incisional hernia. Mortality was null. Mean postoperative hospitalization time was less than 3 days. We conclude that laparoscopic activity in a teaching center allows acquisition of a new technique modality while remaining safe for patients.