Cholecystectomy

Abstract

Laparoscopic cholecystectomy became the procedure of choice for treatment of symptomatic gall stone disease, and nowadays it is considered to be the gold standard. In the United Stated 90 % of cholecystectomies are performed laparoscopically. In spite of improvement of instrumentation, surgical techniques and growing experience of surgeons in laparoscopic procedures the morbidity rate, due to major biliary tract injuries remains relatively high (0.3–0.5 %). This not only has a dramatic impact on the wellbeing of patients but also generates high costs of treatment and leads to medical legal litigation driving up health care costs. Salvader et al. estimated that laparoscopic cholecystectomy-related bile duct injuries were associated with an additional 50,000 US Dollars in costs, 32 days of inpatient hospitalization, 378 days of chronic biliary intubation, and 4 % mortality per case. Adopting the concept of a “standardized operative procedures (SOP)” approach is of paramount importance to assure safety and quality of performance. Breaking up a procedure in component tasks and executing these tasks meticulously can undoubtedly reduce risks of complications in any kind of surgical procedure and certainly in laparoscopic cholecystectomy.