Twelve Hundred Open Cholecystectomies Before the Laparoscopic Era

Abstract

Records of 1200 consecutive open cholecystectomies, performed by a teaching service of a large, urban hospital in the years immediately preceding the laparoscopic era, were reviewed for morbidity and mortality rates. The mortality rate in this series was 1.8%, chiefly in the older age groups. Only two ductal injuries were incurred. A review of published series from 1952 through 1990 revealed a mean mortality rate of 1.53%. These recent observations on the morbidity and mortality after open operation should provide a useful standard of comparison with ongoing similar studies of laparoscopic cholecystectomy.

Symptomatic outcome following laparoscopic cholecystectomy

“…This has important implications for community care of the elderly 6 . By contrast with one previous report 2,6 93% of the patients who responded to the survey were pleased with the end result of the procedureand despite the frequent persistence of abdominal symptoms. A similar frequency of overall improvement despite a high number of patients with persistent abdominal pain post cholecystectomy has been reported previously 4 .…”

“…Loss of reservoir function of the gall bladder, which results in disturbance of bile metabolism and entero-hepatic cycling has been implicated as a cause. 1,2 .This study was designed to assess symptomprevalenceof patients with symptomatic gallstone disease during pre and postlaparoscopic cholecystectomy.…”

Biliary tract injuries after lap cholecystectomy—types, surgical intervention and timing

“…Biliary leakages are considered an early complication and biliary strictures are a late complication. It is observed that the rate of clinically-relevant bile leaks after conventional open cholecystectomy ranges was between 0.1% and 0.5% (1)(2)(3). Biliary leakages have increased after the development of laparoscopic cholecystectomy (LC) by up to 3% (4)(5)(6)(7).…”

Management of Common Bile Duct Stones in the Laparoscopic Era

“…Open CBDE has been shown in RCTs to result in morbidity ranging from 11 % to 14 % and mortality from 0.6 % to 1 % [5]. Interestingly, Morgenstern et al [29] reported on 220 open CBDE before the laparoscopic revolution. Their results revealed no mortality in patients under 60 years of age and 4.3 % mortality in those over 60.…”