Surgical audit of laparoscopic cholecystectomy at the Jordanian royal medical services hospitals

Abstract EN

Objective : to assess the achieved quality level of laparoscopic cholecystectomy in the Royal Medical Services hospitals after 13 years from its application in treatment of gallstone disease, and to compare this with the quality level of laparoscopic cholecystectomy in widespread use.

Methods : during the period from the 1st of January 1995 to the 31st of May 2004, 1410 patients underwent laparoscopic cholecystectomy by one out of eight surgical teams.

These patients were enrolled in a retrospective analysis.

Data were collected in the following categories : individual patient data, risk factors, preoperative work up, intra-operative findings, intra-operative complications, operative time, histopathological findings, and postoperative course and complications.

Results were compared with recent similar worldwide data.

Results : out of the 1410 patients, 1125 (79.8 %) were females and 285 (20.2 %) were males.

Age ranged between 12 and 90 years with a mean of 46.7.

Average weight for females was 70.5 kg and 80.6 kg for males.

Operative time ranged between 25 to 126 minutes with a mean of 56 minutes.

Intra-operative complication rate was 34.3 %.

Most of them were minor and only 1.9% needed conversion to conventional cholecystectomy.

In 65 patients (4.6 %) laparoscopic cholecystectomy was converted to conventional open cholecystectomy.

Conversion rate was related to sex and histopathological diagnosis with a high statistical significance.

Postoperative complications occurred in 83 patients (5.9 %).

Histopathological diagnosis was chronic cholecystitis in 1252 patients (88.8 %), acute cholecystitis in 149 patients (10.6 %) and adenocarcinoma of the gall bladder in 9 patients (0.64 %).

There were no mortalities.

Data compared favorably with worldwide similar data.

Conclusion: Laparoscopic cholecystectomy as a gold standard procedure in the treatment of gall bladder stone related disease has reached a high quality level in the Royal Medical Services hospitals compared to that in worldwide use.