Complications of Laparoscopic Cholecystectomy and its Management

Iffat Tahira, Iqra Abbas, Shakiba Sarwar

Abstract


Objective: To determine frequency of various complications associated with laparoscopic cholecystectomy and various modes of its management.

Study design & duration: This is a cross sectional study started in January 2018 and completed in August 2018 consisted on total duration of 8 months.

Setting: Study was conducted in general surgery ward of Nishter Hospital Multan

Patients and methods: Total 100 cases were included in this, which were admitted in the ward for laparoscopic cholecystectomy due to cholelithiasis. Both male and female cases irrespective of their age were included in the study. These cases were admitted via OPD. After getting all necessary investigations diagnosis was confirmed and they were planned for laparoscopic cholecystectomy. Those planned for open cholecystectomy were not included. All relevant data such as age, gender, diagnosis, history and important points of physical examination were documented properly. Anesthesia fitness of all cases was taken before operation. These cases were retained in the ward for 2-10 days.   

Results: Total 100 cases were included in this study.  There were 5 cases having age 20-30 years, 30 cases were between 31-40 years age, 40 cases were between 41-50 years age, 15 cases between 51-60 years and 10 cases having age above 60 years.  Out of 100 cases 6 cases got complications in laparoscopic cholecystectomy. Partial injury to CBd occurred in 4(4%) cases, partial injury to CHD occurred in one case and complete transaction of CBD happened in one case.  Modes of treatment were laparotomy and T-tube insertion, placing drain usg guided.   

Conclusion: Laparoscopic cholecystectomy is modern technique with minimum complications and more successful in modern world. Minimum dissection of soft tissues and good exposure.


Keywords


Laparoscopy, Cholecystectomy, common bile duct, common hepatic duct, bile duct injury

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References


Davidoff AM, Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg 1992; 215: 196–202.

Moosa AR, Easter DW, Van Sonnenberg E, Casola G, D’Agostino H. Laparoscopic injuries to the bile duct: a cause for concern. Ann Surg 1992; 215: 203–208.

Carroll BJ, Friedman RL, Liberman MA, Phillips EH. Routine cholangiography reduces sequelae of common bile duct inju-ries. Surg Endosc 1996; 10: 1194–1197.

Targarona EM, Bendahan GE. Management of common bile duct stones: controversies and future perspectives. HPB (Ox-ford). 2004;6(3):140-3.

Mir IS, Mohsin M, Kirmani O, Majid T, Wani K, Hassan MU, Naqshbandi J, Maqbool M. Is intra-operative cholangiogra-phy necessary during laparoscopic cholecystectomy? A mul-ticentre rural experience from a developing world country. World J Gastroenterol 2007; 13(33): 4493-4497

Way LW, Admirand WH, Dunphy JE Management of choledo-cholithiasis. Ann Surg 1972; 176: 347–359

Piacentini F, Perri S, Pietrangeli F, Nardi M Jr, Dalla Torre A,

Nicita A, Lotti R, Castaldo P, Gabbrielli F, Castiglia D, Cit-one G. Intraoperative cholangiography during laparoscopic cholecystectomy: selective or routine? G Chir 2003; 24: 123-128

Vezakis A, Davides D, Ammori BJ, Martin IG, Larvin M, Mc-Mahon MJ. Intraoperative cholangiography during laparo-scopic cholecystectomy. Surg Endosc 2000; 14: 1118–1122

Palanivelu C. Intraoperative Cholangiography. In: Art of lap- aroscopic surgery- Textbook and Atlas. India: Jaypee Broth-ers Medical Publishers (P) Ltd, 2007: 585-592.

Ledniczky G, Fiore N, Bognar G, Ondrejka P, Grosfeld JL. Evaluation of perioperative cholangiography in one thousand laparoscopic cholecystectomies. Chirurgia (Bucur) 2006;

Uccheddu A, Pisanu A, Cois A, Cillara N. Can intraoperative cholangiography be avoided during laparoscopic cholecys-tectomy? Chir Ital 2005; 57: 571-577

Tan JT, Suyapto DR, Neo EL, Leong PS. Prospective audit of laparoscopic cholecystectomy experience at a secondary re-ferral centre in South australia. ANZ J Surg 2006; 76: 335-338

Caratozzolo E, Massani M, Recordare A, Bonariol L, Anto-niutti M, Jelmoni A, Bassi N. Usefulness of both operative cholangiography and conversion to decrease major bile duct injuries during laparoscopic cholecystectomy. J Hepatobil-iary Pancreat Surg 2004; 11: 171-175

Hamouda AH, Goh W, Mahmud S, Khan M, Nassar AH. In-traoperative cholangiography facilitates simple transcystic clearance of ductal stones in units without expertise for lap-aroscopic bile duct surgery. Surg Endosc 2007; 21: 955- 959

Sarli L, Costi R, Roncoroni L. Intraoperative cholangiography and bile duct injury. Surg Endosc 2006; 20: 176-177


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