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[Laparoscopic cholecystectomy. Report of the first 1300 cases carried out by a multidisciplinary team]
M A Martinez1, J Ruíz, R Torres
1Centro de Cirugía Endoscópica, Hospital Universitario General Calixto García, La Habana, Cuba.
Abstract:
Nowadays, the laparoscopic cholecystectomy has been accepted as the more effective and safe procedure for the treatment of symptomatic gallstones. The present issue shows the initial result in the management of 1300 patients undergoing laparoscopic cholecystectomy, by a surgical team integrated by experienced endoscopist and surgeons. The diagnosis and treatment of common duct stones were performed preoperatively in 35 patients (2.7%). The ERCP, with endoscopic sphincterotomy and stone extraction was performed in all cases. The overall conversion rate to open cholecystectomy was 0.8%. The technical difficulty to identify the structures was the more frequent cause of conversion. On the other hand, the complication rate was 2.5%, there were no bile duct injuries, and the mortality associated was 0.15%. The 92.8% of our patients was discharged within 24 hours of surgery. We conclude that the medical team, integrated by endoscopist and surgeons, offer to patient an organic and sequential management of their illness; moreover, this was decisive to obtain lower rate of complications, mortality and conversion.