Complications after laparoscopic cholecystectomy.

After becoming alarmed about seven unusual and severe complications reported by New York State hospitals after laparoscopic cholecystectomy, the Department of Health of New York State tabulated all reported adverse incidents. After observing unusual injuries to the great vessels of the abdomen and an increase in major bile duct injury during laparoscopic cholecystectomy, the Department of Health prepared a memorandum to New York State hospitals advising closer attention to education, credentialing, proctoring, and outcome after these operations. The frequency of cholecystectomy has increased sharply, by 21%, since the advent of laparoscopic cholecystectomy. The serious injury rate may be approximately 15 times that observed after an open cholecystectomy. Recognizing the theoretic advantages of the procedure, the Department of Health reminded hospital Boards of Trustees of their obligation to establish mechanisms for credentialing and privileging surgeons and surgical teams so that the risks do not exceed those expected of the open procedure and to detect and correct deviations from this standard.