[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
May 1992

Laparoscopic CholecystectomyA Clinical and Financial Analysis of 280 Operations

Author Affiliations

From the Division of General and Vascular Surgery, Department of Surgery, The Fallon Clinic, St Vincent Hospital, and the University of Massachusetts Medical School, Worcester, Mass.

Arch Surg. 1992;127(5):589-595. doi:10.1001/archsurg.1992.01420050117015
Abstract

• Two hundred eighty patients underwent laparoscopic cholecystectomy (LC) and were compared with 304 patients who underwent traditional "open" cholecystectomy (OC). Laparoscopic cholecystectomy was performed electively in 72.5% of cases and urgently in 27.5% of cases. Conversion from LC to OC was required in 14 patients (5%), six of whom required common bile duct exploration. Common bile duct stones were managed with video-laparoscopic techniques in 11 patients, with percutaneous transhepatic laser lithotripsy in three patients, and with laparotomy in six patients. Hospital stay was significantly shorter and complications were significantly fewer for LC compared with OC. Hospital expenses for LC were significantly higher than for OC because of longer duration of operation and higher operating room expenses. Patients who underwent elective LC returned to work an average of 31 days earlier than patients who underwent OC (10 days vs 41 days). These data indicate that LC can be performed safely although at a higher cost than OC, and that patients as well as employers benefit from a short length of hospital stay.

(Arch Surg. 1992;127:589-595)

References
1.
Dubois F, Berthelots G, Levard H.  Cholecystectomy par coelioscopie . Presse Med . 1989;18:980.
2.
Meyers WC, Branum GD, Farouk M, et al.  The Southern Surgeons Club: a prospective analysis of 1518 laparoscopic cholecystectomies . N Engl J Med . 1991;324:1073-1078.Article
3.
Graves HA Jr, Ballinger JF, Anderson WJ.  Appraisal of laparoscopic cholecystectomy . Ann Surg . 1991;213:655-664.Article
4.
Schirmer BD, Edge SB, Dix J, Hyser MJ, Hanks JB, Jones RS.  Laparoscopic cholecystectomy: treatment of choice for symptomatic cholelithiasis . Ann Surg . 1991;213:665-677.Article
5.
Gadacz TR, Talamini MA.  Traditional versus laparoscopic cholecystectomy . Am J Surg . 1991;161:336-338.Article
6.
Olsen DO.  Laparoscopic cholecystectomy . Am J Surg . 1991; 161:339-344.Article
7.
Frazee RC, Roberts JW, Okeson GC, et al.  Open versus laparoscopic cholecystectomy: a comparison of postoperative pulmonary function . Ann Surg . 1991;213:651-654.Article
8.
Peters JH, Ellison EC, Innes JT, et al.  Safety and efficacy of laparoscopic cholecystectomy: a prospective analysis of 100 initial patients . Ann Surg . 1991;213:3-12.Article
9.
Ponsky JL.  Complications of laparoscopic cholecystectomy . Am J Surg . 1991;161:393-395.Article
10.
Veress J.  Neues Instrument zue Aufuhrung von Brust Oder Bauchpunktionen . Dtsch Med Wochenschr . 1938;41:1480-1481.Article
11.
Hasson HM.  A modified instrument and method for laparosurgery . Am J Obstet Gynecol . 1971;110:886-887.
12.
Reddick EJ, Olsen DO.  Outpatient laparoscopic laser cholecystectomy . Am J Surg . 1990;160:485-487.Article
13.
Flowers B, Saslawsky M, Mathes G, Tonkin A.  Use of the pulsed dye laser and ultrasonic litho-tripter for removal of multiple intrahepatic gallstones . Surg Gynecol Obstet . 1990;170:443-444.
14.
Berci G, Hamlin JA, Daykhovsky L, Paz-Partlow M.  Common bile duct laser lithotripsy . Gastrointest Endoscop . 1990;36:137-138.Article
15.
Stoker ME, Leveillee RJ, McCann JC, Maini BS.  Laparoscopic common bile duct exploration . J Laparoendoscop Surg . 1991;1:287-293.Article
16.
McSherry CK.  Cholecystectomy: the gold standard . Am J Surg . 1989;158:174-178.Article
17.
Society of American Gastrointestinal Endoscopic Surgeons.  Granting of privileges for laparoscopic general surgery . Am J Surg . 1991;161:324-325.Article
18.
Wittgen CM, Andrus CH, Fitzgerald SD, Baudendistel LJ, Dahms TE, Kaminski DL.  Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy . Arch Surg . 1991;126:997-1001.Article
19.
Berci G, Sackier JM, Paz-Partlow M.  Routine or selected intraoperative cholangiography during laparoscopic cholecystectomy? Am J Surg . 1991;161:355-360.Article
20.
Pasquale MD, Nauta RJ.  Selective vs routine use of intraoperative cholangiography: an argument . Arch Surg . 1989;124:1041-1042.Article
21.
Stain SC, Cohen H, Tsuishoysha M, Donovan A.  Choledocholithiasis: endoscopic sphincterotomy or common bile duct exploration . Ann Surg . 1991;213:627-634.Article
22.
Neuhaus B, Safrany L.  Complications of endoscopic sphincterotomy and their treatment . Endoscopy . 1981;13:197-199.Article
23.
Capuano LR, Brand RK, Mumtay A.  treatment strategies for managing gallstones: a cost analysis . Med Interface . 1989;2:26-33.
×