Laparoscopic laser cholecystectomy. Results of 100 successful operations.

ABSTRACT

It would seem that laparoscopic laser cholecystectomy is a safe and reasonable procedure. We feel that it will be indicated for most patients with symptomatic gallbladder disease. The only distinct contraindications which we have noted are multiple prior upper abdominal procedures, common bile duct obstruction, or intense acute inflammation. However, as experience has widened, even some of the above problems may be manageable with laparoscopic technique. We would expect that the technique can be attempted on at least 90% of patients with proven gallbladder disease and that this percentage may increase with further experience. Our experience suggests that there is probably no increased operative risk with this operation. Any potential risks associated with pneumoperitoneum and introduction of laparoscopic instruments is more than offset by higher morbidity associated with open techniques. Besides the obvious economic benefits of shorter hospital stay and recovery time and rapid return to self-care and employment, this operation is quite rewarding for both surgeon and patient due to the decrease in post-operative pain and discomfort and a striking decrease in pulmonary problems, phlebitis and other complications of more invasive procedures. We expect this to become the standard procedure for gallbladder disease as experienced is widened.