The early experience with laparoscopic cholecystectomy in Oregon

K. E. Deveney
Department of Surgery, Oregon Health Sciences University, Portland.

OBJECTIVE: To obtain a profile of laparoscopic cholecystectomy (LC) across the state of Oregon with regard to the safety of the procedure, use of intraoperative cholangiograms, and requirements for granting surgeons privileges to perform LC and other laparoscopic procedures. DESIGN: Single-mailing survey to surgeons and chiefs of surgery in Oregon. SETTING: The state of Oregon. STUDY PARTICIPANTS: Surgeons and chiefs of surgery in Oregon. INTERVENTION: None. MAIN OUTCOME MEASURE: Numbers of procedures performed, deaths, complications, and requirements for surgical privileges. RESULTS: Sixty-nine percent of surgeons returned the questionnaire, as did 53% of the chiefs of surgery. Four deaths (0.04%), 244 complications (2.5%), and 27 bile duct injuries (0.28%) were reported in 9597 patients undergoing LC. Most surgeons (55%) obtained intraoperative cholangiograms routinely. Requirements for the privilege to perform LC varied among hospitals. Although the accuracy of this self-reported survey is uncertain, the results agree with those of other reports published to date. CONCLUSION: Laparoscopic cholecystectomy is being performed with acceptable safety, although the process of granting surgeons the privilege to perform this and other "new" laparoscopic procedures should be standardized according to established guidelines.