2007, Number 2
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ABSTRACTObjective: To present the experience attained at the General Hospital of Mexico regarding the learning curve for laparoscopic cholecystectomy.
Setting: Third level health care center.
Design: Retrospective, transversal, comparative study.
Statistical analysis: Percentages as summary measure for qualitative variables and chi square test.
Material and methods: We reviewed the clinical records of patients subjected to laparoscopic cholecystectomy in two periods of seven years each. Analyzed variables were: age, gender, use of the procedure, conversion frequency, complications, and surgical time.
Results: From a total of 14,950 cholecystectomies, 5,011 were laparoscopically approached at a 1:1.9 relation; predominating women over men at a 4.3:1 relation, average age was of 68 years. The frequency in the use of the procedure increased between the two analyzed periods from 34 to 42% (p ‹ 0.001). Conversion decreased from 4.4% to 2.6% (p ‹ 0.001). Seven cases of injury to the extra-hepatic biliary tract were recorded in the first period and four in the second (p › 0.05), with a total frequency of 0.20%. Surgical time decreased in average from 4 hours to 35 minutes.
Conclusions: 1. The conversion percentage and surgical time tends to decrease with time. 2. Causes for conversion are similar to those reported worldwide. 3. Frequency of biliary tract injury lies within internationally reported ranges.
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