National survey on laparoscopic cholecystectomy in Spain

Abstract

We present a joint study conducted by the Committee for Endoscopic Surgery in Spain. Sixty-nine surgeons reported 2,342 laparoscopic cholecystectomies (LCs) performed until November 1992. The conversion rate was 5.1%. The overall morbidity was 7.1%. The biliary morbidity was 0.45%: Seven severe bile duct injuries were recognized at laparoscopy (0.28%) and four lesions were postoperatively diagnosed (0.16%). Bile leak unrelated to bile duct lesion occurred in 14 patients (0.7%), leading to five reoperations. The mortality was 0.12% and was unrelated to the laparoscopic approach in two cases. The risk factors for biliary complications were obesity, previous history of jaundice, and previous hospital admissions. Surgeon experience was defined by 50 LCs performed and the overall complication rate presented a statistically significant relation to surgeon experience (P < 0.001).

Prospective, randomized trial of bipolar electrosurgery vs ultrasonic coagulation for division of short gastric vessels during laparoscopic Nissen fundoplication

“…Retrospectively, obesity has been correlated with increased operative times for laparoscopic cholecystectomy [38]. Previous prospective data for laparoscopic cholecystectomy has not demonstrated a significant correlation between laparoscopic operative times and obesity [29], but has shown obesity to be a risk factor for biliary injury [43]. To the authors' knowledge, this is the first prospective series to demonstrate a direct correlation between BMI and laparoscopic operative times.…”

Endocrine and metabolic response to gastric bypass

“…The 30-day postoperative mortality for laparoscopic RYGB may be as low as 0.17% [7•], similar to cholecystectomy (0.12%) [8], although the mortality rates for cholecystectomy in obese individuals can be higher [9•]. …”