Recentely laparoscopic Cholecystectomy is being rapidly emerged. It is a minimally invasive procedure whereby the gallbladder is removed using laparoscopic techniques. The procedure offers the patient reduced hospital stay, faster to work, less pain, less complication, less expensiveness, and improved Cosmetic results over the traditional oper cholecystectomy. Cholecystectomy for treatment of cholelithiasis or gallbladder polyp was performed in 294 patients at Anam Hospital, Korea University. Out of them, 18 persons were performed with traditional open procedure from September 1990 to June 1993(A group), 176 persons with laparoscopic procedure from September 1991 to September 1992(B group). We compared the diagnostic the diagnostic tools, previous operative historym, associated disoder, operative time, postoperative condition, hospital stay, gallbladder pathology, conversion to open cholecystectomy, complicationm and hospital costs between A and B group. The result were as follows;

1) Mean ages between A group(52.6 years old)and B group(54.6 years old) were not significantly different. Sex ratio were 1:1.4 in male and female in A group and 1:2 in B group.

2) Diagnostic procedures were abdominal sonogram without other study(61%), ERCP(29%), and abdominal CT(4%) including abdominal sonogram in A group, oral cholecystogram(50%), and ERCP(35%) including abdominal sonogram and without other study(13%) in B group in order of frequency.

3) Average operative times were 64.8 min. in A group, 65.6 min. in B group, but laparoscopic operative time decreased with experience.

4) Laparoscopic cholecystectomy was performed in 30 patients(17%), who had previous abdominal operative history which had been commonly considered relative contraindication of Laparoscopic cholecystectomy.

5) Conversion to open operation was necessary in 10 of 176 patients(5.7%). The cause of conversion was severe adhesion in 4 patients, active bleeding in 2 patients, contracted gallblader with bleeding in 2 patients, and suspected GB cancer in 2 patients.

6) The complication rate was 8.5%, and wound infection(5.1%), pulmonary complication(2.5%) bleeding through drain(0.8%) in order of frequency in A group. It was 6.3%, and mild wound pain, prolonged ileus and bleeding in order of frequency in B group.

7) Average postoperative hospital stay was 7.4 days in A group and 3.2 days in B group.

8) Hospital costs was 1,327,313 won in A group and 2,208,461 won in B group.

Laparoscopic cholecystectomy is safe and effective therapeutic modality which was compared to open cholecystectmoy for cholelithiasis.

Keywords: Cholelithiasis, Laparoscopic cholecystectomy