Attuali indicazioni alla colecistectomia laparoscopica.

The authors report their experience with 215 consecutive laparoscopic cholecystectomy performed, between August 1991 and December 1993, at St. Vincent's Hospital - Rome. 134 patients did not show relative contraindications to perform laparoscopic cholecystectomy, of the remaining 81 patients: 23 had undergone an open laparotomy, 21 had acute cholecystitis, 10 were obese, 11 had associated choledocholithiasis, 9 were cirrhotics, 15 were over 70 years old, 8 had combinations of two of the above conditions. It was always possible to perform laparoscopic cholecystectomy, except for two cases with previous open laparotomy, in these patients it was necessary to convert to open cholecystectomy. There was no mortality. In the group with relative contraindications morbidity was not much higher (6.1 vs 4.8%), the mean postoperative hospital stay was nearly 1 day longer (3.6 vs 2.8 days). The authors conclude that the laporoscopic procedure should be accept as the treatment of choice for all patients undergoing cholecystectomy.