Complications of laparoscopic cholecystectomy in Hungary: a multicentre study of 13,833 patients.

Objective: To report our countrywide experience of laparoscopic cholecystectomy with particular reference to complications.

Design: National multicentre retrospective study.

Setting: 71 university departments and public hospitals in Hungary.

Subjects And Interventions: 13,833 patients operated on between 1 January 1990 and 31 December 1993. Follow up by questionnaire.

Results: 732 patients (5.3%) required conversion to open cholecystectomy, urgently because of intraoperative complications in 204 (1.5%), electively for acute or chronic inflammation or obscure anatomy in 441 (3.2%), for unexpected findings in 72 (0.5%) and for technical problems in 15 (0.1%). There were postoperative complications in 598 (4.3%) but reoperation was indicated in only 154 patients (1.1%). There were bile duct injury in 81 (0.6%) and 199 bleeds (1.4%) which required conversion in 102 patients (0.7%) and reoperation in 38 (0.3%). 36 of the 181 postoperative recognized bile leaks required reoperation (20%). 19 patients died (0.1%).

Conclusions: The morbidity and the mortality of laparoscopic cholecystectomy are better than after the open operation. The 2-6 times higher risk of bile duct injury mentioned in early studies was not confirmed.