Laparoscopic cholecystectomy: 700 consecutive cases.

From March 1993 till June 1995 700 laparoscopic cholecystectomies have been performed on 590 female and 110 male patients who ranged form 10 to 82 years of age at the Departments of Surgery of County Hospital and Alexander's University Hospital in Sofia. Ninety seven of the patients (13.8%) who have had laparoscopic cholecystectomies (LC) were diagnosed as acute cholecystitis and the rest as chromic calculous cholecystitis. In 16 cases (2.28%) a conversion to standard open cholecystectomy was necessary, the most frequent causes being intraoperative bleeding and unsuspected preoperatively common bile duct stones. Immediate or early postoperative laparotomy was performed in four cases because of biloma (1), small intestine strangulation in the umbilical region (1), perforated duodenal ulcer (1), bleeding (1). One case required laparotomy and removal of a clip misplaced tangentially to the right hepatic duct. There were no cases with lethal outcome following LC. Sixty-five patients have had intraoperative cholangiography and 14 patients underwent concomitant laparoscopic choledochotomy and a common bile duct stones extraction.