Laparoscopic cholecystectomy: 563 cases at a community teaching hospital and a review of 12,201 cases in the literature. Monmouth Medical Center Laparoscopic Cholecystectomy Group.

Eleven surgeons attempted laparoscopic cholecystectomy in 563 patients over a 14-month period. Of these 563, 536 (95.3%) were performed successfully; the remaining patients required conversion to laparotomy, but only five because of complications. There were no mortalities associated with the procedure. Thirty-nine patients had complications, 14 surgical and related to the procedure itself. Weight was not considered a contraindication. The preoperative diagnosis in 83.6% patients with chronic cholecystitis, and in the remainder (16.4%) it was acute cholecystitis. Mean operative time was 86.4 min, and mean hospital stay for uncomplicated successful laparoscopic cholecystectomy was 1.9 days. An extensive review of the literature reveals an additional 9,792 laparoscopic cholecystectomies performed at the time of the writing of this paper. Our results compare favorably to these. A discussion of historical aspects of the procedure, contraindications to laparoscopic cholecystectomy, and the merits of selective intraoperative cholangiography are also presented.