Laparoscopic cholecystectomy (LC) was attempted in 300 consecutive
patients. 292 patients (97.3%) presented on an elective basis for
symptomatic chronic calcular cholecystitis, and the remaining 8 patients
(2.7%) were admitted for acute cholecystitis. 26 (8.6%) were obese and 6
patients have upper or right paramedian scars after previous abdominal
operations. These difficulties required some precautions during insertion of
trocars and meticulous technique for acute cases. Careful identification of
cystic artery anomalies by combination of sharp and blunt dissection
reduced the frequency of bile duct injuries which were recorded to be 0.7%
(2 patients). These two patients were among the group required conversion
to open cholecystectomy; 19 patients (63%). No mortality was reported in
the included patients while the morbidity rate reached to 5.7% (17 patients).
It is concluded that LC can be performed safely even in some difficult cases,
and its complications can be prevented by proper patient selection
according to surgeon experience and by election to convert to open
cholecystectomy than to be forced to do so. |
