BACKGROUND AND AIMS: The authors analyse their first two years of experience regarding the use of laparoscopic cholecystectomy and report the results of this series and their observations. METHODS: A total of approximately 200 cholecystectomies have been performed using a laparoscopic technique at S. Paolo Hospital in Naples (Department of Surgery; Head: Prof. R.A. Caliendo) since October 1996. Initially patients were rigorously selected in accordance with international criteria. At present, after the good results obtained, the real contraindications to laparoscopic cholecystectomy are considered to be: a) the patient's refusal; b) general conditions that do not allow the use of general anesthesia in surgery. RESULTS: None of these 200 patients was converted to open surgery, although six complications occurred: four of these were cases of bleeding in which it was decided to choose a carefully monitored wait-and-see approach. Mean postoperative hospitalisation was two days. No major postoperative complications were observed and it was not necessary to keep any patient for more than five days. CONCLUSIONS: On the basis of this experience, the authors underline the value of laparoscopic surgery versus open cholecystectomy (reduced morbidity, shorter hospitalisation with marked social and economic advantages). Furthermore, the authors emphasise that, when laparoscopy is first introduced, it is important for the same operating team always to be present in order to ensure a good learning curve and increasing familiarity with the technique.
BACKGROUND AND AIMS: The authors analyse their first two years of experience regarding the use of laparoscopic cholecystectomy and report the results of this series and their observations. METHODS: A total of approximately 200 cholecystectomies have been performed using a laparoscopic technique at S. Paolo Hospital in Naples (Department of Surgery; Head: Prof. R.A. Caliendo) since October 1996. Initially patients were rigorously selected in accordance with international criteria. At present, after the good results obtained, the real contraindications to laparoscopic cholecystectomy are considered to be: a) the patient's refusal; b) general conditions that do not allow the use of general anesthesia in surgery. RESULTS: None of these 200 patients was converted to open surgery, although six complications occurred: four of these were cases of bleeding in which it was decided to choose a carefully monitored wait-and-see approach. Mean postoperative hospitalisation was two days. No major postoperative complications were observed and it was not necessary to keep any patient for more than five days. CONCLUSIONS: On the basis of this experience, the authors underline the value of laparoscopic surgery versus open cholecystectomy (reduced morbidity, shorter hospitalisation with marked social and economic advantages). Furthermore, the authors emphasise that, when laparoscopy is first introduced, it is important for the same operating team always to be present in order to ensure a good learning curve and increasing familiarity with the technique.