Purpose
The laparoscopic cholecystectomy has become a common procedure for treating gallbladder disease. The objectives of this study was to evaluate the learning curve by reviewing 145 patients treated with laparoscopic cholecystectomy, between Group A
(From
January 1991 to December 1995) and Group B (From January 1996 to December 2000).
Methods
We retrospectively analyzed 145 laparoscopic cholecystectomies performed at the Department of General Surgery, National Medical Center, from January 1991 to December 2000. The sex, age, operation time, associated disease, previous operation
history,
hospital stay, and pathology were reviewed.
Results
The ratio of Females to males was 1.9：1, and their age ranged from 18 to 80 years with the majority in their fifties and sixties. Most of the operative indications were cholelithiasis. The mean operative time was 89 minutes, which varied between
40 and
180 minutes, and the average admission time was five days. The operation times of Group A and Group B were statistically significant with respect to learning curve (p value＜0.000). A linear regression test of the operation time and operation
cases
was
also significant. The postoperative analgesic injection and hospital stay were improved in Group B, but had no statistical significance. A conversion to open cholecystectomy was done in four cases due to bleeding, severe adhesion, or clip
migration
of
the cystic duct during surgery.
Conclusion
The laparoscopic cholecystectomy was a safe and effective treatment for gallbladder disease, and we predict that the operation time will become shorter with more experience.
|