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An initial experience of laparoscopic cholecystectomy in 50 consecutive patients was reviewed and the results compared with those of a group of 25 patients who underwent laparotomy cholecystectomy during the 3 months before the introduction of laparoscopic cholecystectomy. Laparoscopic cholecystectomy was successfully performed in 44 of 50 consecutive patients in whom it was attempted. When compared with laparotomy, laparoscopy cholecystectomy was associated with longer mean (s.d.) anaesthesia, 155 (61) min versus 102 (31) min (P less than 0.001), shorter mean postoperative hospital stay, 3.5 (1.5) versus 8.8 (3.2) days (P less than 0.001), and reduced mean cost, pounds 895 (376) versus pounds 2210 (822) (P less than 0.001). Perioperative morbidity was also reduced following laparoscopy cholecystectomy (9 per cent versus 16 per cent) but not significantly so. Laparoscopic cholecystectomy is a safe, effective procedure which completely removes the gallbladder. It significantly reduces hospital stay, is cosmetically satisfactory and has financial benefits. We suggest that this technique be considered for all patients having cholecystectomy.