The surgical word for the 1990s is laparoscopy. Driven by the patient's desire for less pain, an extremely short recovery period (when no complications are present), a desire for sales by the medical-industrial complex, and efforts by surgeons to keep or enlarge their market share, laparoscopic techniques, mainly cholecystectomy, are a bull market.
Accessories to this trend are anesthesiologists, who benefit from longer operating times as the new technique is learned; hospitals, whose operating rooms are filled; and lawyers, whose personal injury suits are more numerous. Third-party payers thought they would benefit from shorter hospitalizations, but because asymptomatic or mildly symptomatic patients with gallstones now become surgical patients, the number of cholecystectomies and third-party costs will probably increase.
These considerations are relatively unimportant when judged by the scale of general health and safety. Undoubtedly, the risk of bile duct damage increases with the laparoscopic procedure compared with open cholecystectomy.1,2