Laparoscopic cholecystectomy in XXXX .

@entity1 @entity788 @entity2963 @entity281 @entity2877
Laparoscopic cholecystectomy has emerged as the treatment of choice for uncomplicated @entity2963 . Despite early concerns, many surgeons have applied this new technique to more complicated biliary tract disease states, including @entity788 . To evaluate the safety of laparoscopic cholecystectomy in this setting, we retrospectively reviewed 29 @entity1 with clinical and laboratory evidence of @entity788 who underwent this procedure between March 1990 and December 1992. The severity of @entity788 was determined by Ranson's criteria. Two @entity1 had a Ranson's score of 6, one of 5, one of 4, five scored 3, nine scored 2, nine also scored 1, and two @entity1 scored 0. The mean serum amylase level on admission was 1,610 (range 148 to 7680). All @entity1 underwent laparoscopic cholecystectomy during the same hospital admission for @entity788 , with the mean time of operation being 5.5 days from admission. Operative time averaged 123 minutes (range 60-220 minutes). Intraoperative cholangiography was obtained in 76 per cent of @entity1 . Three @entity1 had @entity2877 on intraoperative cholangiography and were treated with choledochoscopy, laparoscopic common bile duct exploration, and saline flushing of the duct. The mean length of hospital stay was 11 days (range 5-32 days). There were seven postoperative complications requiring prolonged hospitalization with all but one treated non-operatively. One @entity1 with a preoperative Ranson score of 6 developed necrotizing @entity788 and subsequently required operative pancreatic debridement and drainage. There were no deaths in this series and no postoperative wound @entity281 . The average recovery period for return to work was 2 weeks. These statistics compare favorably with literature reports for open cholecystectomy in @entity788 .(ABSTRACT TRUNCATED AT 250 WORDS)
