Laparoscopic Cholecystectomy

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Abstract
Laparoscopic cholecystectomy has revolutionized the treatment of gallstone disease. Since its introduction in the late 1980s, it has virtually replaced open cholecystectomy in uncomplicated cases. Its rapid adoption by surgeons in community practice, stimulated by demand from patients aware of the procedure's apparent virtues in comparison with conventional surgery, preceded any formal evaluation of its benefits and risks by academic centers. Nevertheless, a National Institutes of Health Consensus Conference in September 1992 concluded that laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones and that it offers distinct advantages over open cholecystectomy by decreasing postoperative pain and disability.1 See also p 1429. Hence, it may not be surprising that Legorreta et al2have documented a sharp rise in the rate of cholecystectomy procedures in a large private practice—based health maintenance organization. Using claims data, they found that total cholecystectomy rates increased almost 60%

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