THE MEXICAN EXPERIENCE WITH LAPAROSCOPIC CHOLECYSTECTOMY AND COMMON BILE-DUCT EXPLORATION - A MULTICENTRIC TRIAL

We present here the initial data collected since the first laparoscopic cholecystectomy (LC) was performed in our country (June 1990). Twenty-one centers were surveyed (2,399 patients). The most frequent indication for LC was chronic gallstone disease (76.2%). The female population predominated (69.4%). Seven centers always perform the laparoscopic approach. Antibiotic prophylaxis is the rule, and most centers use nasogastric tube and urinary catheterization. Perioperative cholangiography is done selectively. The instrument of choice to dissect the gallbladder is the electrosurgical hook-knife. General anesthesia is preferred (97%). The complication rate was 8.87%. Injury to the bile duct and bowel perforation occurred in 0.25% and common duct stone retention occurred in 0.29% of patients. Mortality rate reached 0.12%. It is our hope that this study will help in defining the situation of LC in developing countries and that it also can serve as a first step in the organization of minimally invasive surgery groups in Mexico.