[Ten years of experience with laparoscopic cholecystectomy].

UNLABELLED: The laparoscopic cholecystectomy has been performed for almost 20 years in the world. This technique has gained its permanent place in the treatment of cholecystolithiasis. The purpose of this study is the analysis of the results of the treatment of patients with cholecystolithiasis with the use of the laparoscopic technique as we were gaining experience in the field of video-surgical operations.

MATERIAL AND METHODS: In the period from Jan 1993 to Jan 2003 laparoscopic cholecystectomy was performed in 2497 patients with symptomatic cholecystolithasis. An acute cholecystitis was diagnosed in 154 (6.25%) cases. Complications connected with the laparoscopic cholecystectomy appeared in case of 45 (1.8%) patients. While assessing these complications, they were split into intraoperative complications, into early postoperative complications (during the stay in the hospital's department), into late complications, which appeared after the patient's discharge.

RESULTS: The complications appearing during the operation (damage to the common bile duct, damage to the alimentary tract, bleedings) appeared in 0.84% of the patients. Early postoperative complications (prolonged bile leakage, bleedings from the gallbladder bed, from the port sites and from the other vessels) appeared in case of 0.56% of all the operated patients. The late complications (infection of the postoperative wounds, umbilical hernia, and subphrenic abscess) appeared in case of 0.56% patients.

CONCLUSIONS: The laparoscopic cholecystectomy became the method of choice in the treatment of cholecystolithiasis. The percentage of the complications in the use of this technique is comparable with the use of the classical method and it depends on the experience of the operating surgeon.