Laparoscopic cholecystectomy without cholangiography: a study of 151 consecutive cases.

OBJECTIVE

To evaluate the safety of laparoscopic cholecystectomy without operative cholangiography.

DESIGN

Open study.

SETTING

Outpatient and private hospitals, Finland.

SUBJECTS

151 Patients (of whom all but the first 10 were consecutive) with symptomatic gallstones, or chronic or acute cholecystitis.

INTERVENTIONS

Laparoscopic cholecystectomy and (in three patients) preoperative endoscopic retrograde cholangiography (ERC).

MAIN OUTCOME MEASURES

Conversion to open operation and morbidity.

RESULTS

Only 2 patients (2%) required conversion to open cholecystectomy (one bled and in one the anatomy was difficult) and 4 (3%) developed complications (bleeding, n = 2, bile collection, and subcutaneous emphysema as a result of malfunction of the carbon dioxide insufflator). Three patients underwent ERC after operation and two were found to have common duct stones. Both had been noted to have large cystic ducts at operation.

CONCLUSION

Laparoscopic cholecystectomy can be done safely by experienced surgeons without operative cholangiography.