Laparoscopic cholecystectomy: The Finnish experience

Between January 1992 and December 1994, 5,742 patients were treated by laparoscopic cholecystectomy in 35 Finnish hospitals. The operation was converted to open laparotomy in 360 (6.3 %) patients, the most common causes for conversion being technical difficulties in dissection of the gall bladder (2.8 %), bleeding (0.9 %) and bile duct injury (0.48 %). Intraoperative cholangiography was performed selectively in 18 %, and common bile duct stones were found in 10.2 % of these cases. Postoperative complications occurred in 208 (3.6 %) patiens, of whom 65 (1.1 %) required reoperation. Twenty-eight (0.48 %) of these patients had common bile duct injury. In eighteen patients bilio-digestive Roux-en-Y reconstruction was performed, whereas 10 cases could be handled by endoscopic drainage or suturing and T-tube drainage. Thus, the total number of patients with bile duct injury was 56 (0.96 %). The reported hospital mortality was 0.08 %. The mean hospital stay and the mean sick leave were three days (range 1-41) and 13 days (range 1-60), respectively. These data demonstrate that laparoscopic cholecystectomy can be performed with acceptable morbidity and mortality rates as a routine method in various different hospitals.