The evolution of concepts in laparoscopic cholecystectomy in a general surgical clinic from Timis· oara, Romania

Abstract

AIM: The analysis of the progress in the gallbladder laparoscopic surgery by comparing the cases operated after the implementation of this procedure in General Surgery Clinic I of Emergency County Hospital Timisoara, Romania to the current period.

MATERIAL AND METHODS: Two groups of 1000 patients undergoing laparoscopic cholecystectomies have been studied. The first group has been operated between 1994 and 1998, the second group between 2008 and 2011. Analyzed data: surgical indications, the rate of conversions to conventional surgery, intraoperative accidents, postoperative complications and the death rate.

RESULTS: The indications for a laparoscopic approach have been extended from 53 % (530 cases) of the total number of cholecystectomies to 78%(780 cases). The rate of conversions has decreased from 4.9% (26 cases) to 3% (23 cases). The number of patients with acute cholecystitis operated with laparoscopic approach has risen from 48.30 % (256 cases) to 73.07 % (570 cases). The intraoperative accidents and the postoperative complications rate remained unchanged. There were no registered deaths.

CONCLUSIONS: The comparative study has demonstrated the positive evolution of the laparoscopic method due to surgical technique improvement and technological progress. The laparoscopic cholecystectomy is “the gold standard” as an ablation procedure of the gallbladder.