Initial experience with laparoscopic cholecystectomy in a teaching hospital.

The safety of laparoscopic cholecystectomy and the necessary training are serious concerns. This report describes both the surgical experience and the training and credentialling process at a private community-based teaching hospital. All 140 laparoscopic cholecystectomies attempted during the initial 9-month experience (March to December 1990) of 11 surgeons are detailed. There were no deaths. Eight patients subsequently underwent open cholecystectomy, and another two patients required reoperation for complications, which included one common-duct transection. The mean operating time was 106 minutes, the mean hospital stay was 1.6 days and most patients resumed unrestricted activity within 1 week. Use of the laser in 49% of patients was of no discernible benefit. This early experience indicates that laparoscopic cholecystectomy is both safe and effective and should be considered the technique of choice for elective cholecystectomy.