Laparoscopic cholecystectomy was tried in one hundred thirly four patients from July 1991 to April 1994 at Saint Benedict Hospital. And one hundred thirty patients out of one hundred thirty four were succesful and our patients were converted to
open
cholecystectomy. These 130 patients are 36.51% of all cholecystectomy cases including the open cholecystectomy cases between from july 1991 to april 1994 and the rate of the laparoscopic cholecystectomy is increasing with time. The disease
distribution
of 130 cases were as follows: cholelithiasis was 122 patients; choledocholithiasis with cholelithiasis, 1 patient; empyema, 1 patient; acalculous cholecystitis, 2 patients; gall bladder poyp, 2 patients and clonorchiasis, 2 patients. There was no
death
and total postopertive complications were four(3.08%) including postopertive bleeding , postoperative jaundice due to common hepatic duct stricture, bile leakage, and wound infection. The strictured common hepatic duct was reconstructed with
Roux-en-Y
hepaticojejunostomy, but other complicated patients were treatedl with conservtive therapy. Total four cases were converted to open cholecystectomy because of one uncontrolled cystic arterial bleeding, one technical difficulties with empyema and
contracted gall bladder, one multiple adhesions and one choledocholithiasis, each. We evaluated the preopertive patiency of bililary tree throoughly with intravenous cholangiography or endoscopic retrograde cholangiography. Operative
cholangiography was
taken only when the preoperative bile duct patency was not satisfactorily evaluated. Only one bile duct injury was noted during the laparoscopic cholecystectomy in this hospital. We think that the preopertive bile duct evaluation and the
selection
of a
suitable patient for laparoscopic cholecystectomy are important to avoid of bile duct injuries. And it is also important to do laparoscopic cholecystectomy in no hurry and when the operative maneuver is anticipated difficult on viewing
laparoscopic
image, prompt conversion to open method is important to avoid of bile duct injuries.
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