Complications of Laparoscopic Cholecystectomy (original) (raw)
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Complications in Laparoscopic Cholecystectomy: Experiences from A Study of 1425 Cases
Journal of Bangladesh College of Physicians and Surgeons
Objective: To evaluate the complications of laparoscopic cholecystectomy in the symptomatic cholelithiasis and other benign gall bladder diseases. Methods: This descriptive observational study was carried out at CMH Dhaka and CMH Jashore from March 2016 to Jun 2022, to evaluate the frequency and outcome of management of all the complications in laparoscopic cholecystectomy. A total of 1425 patients of laparoscopic cholecystectomy were included in this study. Patients were followed up for a period of three months after operation. The complications in laparoscopic cholecystectomy observed in this study were divided into (i) Access related (ii) Intraoperative (biliary and extrabiliary) and (iii) Postoperative. Results: The incidence of access-related, intraoperative or procedure-related biliary, extrabiliary and postoperative complications were 3.64%, 2.95%, 4.98% and 1.96% respectively. Access related complications were extraperitoneal insufflations 1.40%, port site bleeding 1.19%, sm...
Background: Gallstone disease is a major health problem worldwide particularly in the adult population. Previously complicated gallstone disease was considered to be a contraindication for laparoscopic cholecystectomy. This initial reluctance has slowly evaporated as a result of increasing expertise. The aim of study was to compare the outcome of laparoscopic with open cholecystectomy in patients with complicated gallstone disease. Material & Methods: This study was carried out in Surgical Unit-IV, Liaquat University Hospital Jamshoro, from January 2008 to December 2009. One hundred patients were divided in two groups of 50 each; Group A for open Cholecystectomy (OC) and group B for laparoscopic cholecystectomy (LC). Data was analyzed using SPSS software. Results: Out of 100 patients there was female preponderance with male to female ratio of 1:1.5 in group A and 1:3.5 group B. The mean age was 41.28±12.30 years for group A and 38.44±13.50 for group B. Ultrasound findings revealed was single stone [13(26%) patients in OC vs 10 (20%) patients in LC group], multiple stones [37(74%) patients in OC vs 40 (48%) patients in LC group], Impacted stone [15(30%) patients in OC vs 18 (36%) patients in LC group], Thick wall gallbladder [26(52%) patients in OC vs 25(50%) patients in LC group], empyma [6(12%) patients in OC vs 8(16%) patients in LC group], mucocele [3(6%) patients in OC vs 5(10%) patients in LC group], contracted [7(14%) patients in OC vs 8(16%) patients in LC group]. Operative time range 30 minutes to 90 minutes in both groups. The mean time in OC group was 54.90±15.90 minutes and LC group was 48.30±12.96 minutes (p 0.026). No mortality was reported in this series. Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment of complicated gallstone disease. KEY WORDS: Laparoscopy, Cholecystectomy, Gallstone.
Laparoscopic Cholecystectomy: An Early Experience at A Tertiary Care Hospital in Islamabad
Journal of Community Medicine and Public Health Reports, 2020
Background: Laparoscopic Cholecystectomy first introduced in 1987, is becoming more and more popular and now it has become gold standard in symptomatic gallstone disease. The current descriptive study is carried out in Department of General Surgery, Ayub Teaching hospital, Abbottabad to evaluate the result of Laparoscopic Cholecystectomy in symptomatic gallstones disease in our set up with special emphasis on complication rate, morbidity and mortality. Methods: The data of all patients who underwent Laparoscopic Cholecystectomy form January to December 2007 was entered in standardized proforma and analysed on SPSS 10. Results: Out of 60 patients, 51 (85%) were female and 9 (15%) were males; the age range from 17 to 65 years mean age being 40.30 years, majority were in age 30-40 years group. Two (3.3%) patients had bile leak, 1 (1.3%) patient developed port site wound infection 1 (1.3%) patient developed collection in pouch of Morrison and in 1 (1.3%) patient stone were recovered from the epigastric port site wound. There was no bile duct or colonic injuries. The conversion rate was 5%. There was no mortality. Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment for gall stone disease and is up to the accepted standard in our set up as compared to national and international data.
Study of Problems & Complications During and After Laparoscopic Cholecystectomy
Scholars Journal of Applied Medical Sciences, 2016
Nowadays, laparoscopic cholecystectomy is the procedure of choice for cholelithiasis and a part of general surgical practice. Benefits of this approach include shorter hospital stay, less pain, quicker return to normal activities and improved cosmetic outcome. This study was done to evaluate the problems & complications faced during and after laparoscopic cholecystectomy like adhesions, sessile gallbladder, thickened wall of gallbladder, bleeding, duodenal injury, cystic duct avulsion and miscellaneous causes such as equipment failure, unsuspected pathology or enterobiliary fistula. This study was conducted on 30 patients of gallbladder disease admitted for cholecystectomy in which laparoscopic cholecystectomy was attempted. All the patients were selected at random. In the end it was concluded that adhesions around gallbladder & thickened wall of the gallbladder were the most common problems encountered during this study and intra-operative bleeding & gallbladder wall rupture were the most common complications during surgery. Unforeseen problems like technical failure, due to problem in equipment, can happen during laparoscopic cholecystectomy. Wound infection & fever in the post-operative period were the commonest complications after surgery especially in those patients who had undergone conversion into open cholecystectomy because of intra-operative problems. No wound infection was encountered in cases that underwent successful laparoscopic cholecystectomy.
Laparoscopic Cholecystectomy: An Initial Clinical Experience at Faridpur District
Journal of Current and Advance Medical Research, 2015
Background: Laparoscopic cholecystectomy quickly emerged as an alternative to open cholecystectomy. However its safety, efficacy, and morbidity have yet to be fully evaluated. Objective: The purpose of the present study was to determine the efficacy and safety of laparoscopic cholecystectomy Procedure in the removal of gall bladder stones at Faridpur district-one of the remote district of Bangladesh. Methodology: A prospective, nonrandomized, open label Consecutive study was carried out at Faridpur district using laparoscopic cholecystectomy (LC) procedure for the symptomatic treatment of Gall bladder stones. For this purpose a total number of 145 patients having conclusively diagnosed as gall bladder stones were enrolled. LC procedure was performed by North American technique-a well established and standard procedure described earlier for the purpose. The key variables studied were average operating room time, condition of the gall bladder, the presence or absence of stones, the character of stones, post-operative complicates and duration of hospital stay. Result: The study revealed that among 145 patients 83.4% were female with an average age of 40.3 years. The average operating time required was 130 minutes. Gall bladder was thickened but was free from adhesion in 96.5% cases and stones' only 3.45% patients needed open method due to fibrosis and adhesion of the gall bladder with omentum and gut. The duration of hospital or clinic stay following LC was 3.5 days. Evidence of infection like fever, pain etc. was seen only in 2.75% cases. Bleeding was present in 2.06% cases. This was corrected after blood transfusion. No injury to the common bile duct or any of the bile duct or any of the blood vessels was observed. Similarly no evidence of malignancy was seen in any of the gall bladder removed. Conclusion: The present study concludes that laparoscopic cholecystectomy is a safe, minimal invasive, cost-effective and safe procedure for the symptomatic treatment of gall bladder stones.
Gut, 1993
The pre and postoperative symptoms and outcome after surgery in patients with symptomatic gall stone disease were evaluated by a detailed self administered postal questionnaire. The survey was conducted in two groups: 80 patients treated by laparoscopic cholecystectomy and an age matched cohort of patients who had conventional open cholecystectomy. The overall response rate on which the data were calculated was 76%. Symptomatic benefit ratios accruing from the surgical removal ofthe gall bladder were calculated. The symptoms that were relieved by cholecystectomy were nausea (0.98), vomiting (0-91), colicky abdominal pain (0.81), and backpain (0.76). Flatulence, fat intolerance, and nagging abdominal pain were unaffected as shown by a benefit ratio of 0 5 or less. Relief of heartburn (39/49) outweighed the de novo development of this symptom after cholecystectomy (7/49), resulting in a benefit ratio of 0*65. Postcholecystectomy diarrhoea occurred in 21/118 patients (18%): 10 after open cholecystectomy and 11 after laparoscopic cholecystectomy. The type ofsurgical access did not influence the symptomatic outcome but had a significant bearing on the time to return to work or full activity after surgery (laparoscopic cholecystectomy two weeks, open cholecystectomy eight weeks, p=000001). In the elderly age group (>60 years), significantly more patients (29/30) regained full activity after laparoscopic cholecystectomy when compared with the open cholecystectomy group (16/22), p=OOOl. The patient appreciation of a satisfactory cosmetic result was 72% in the open group compared with 100% of patients who were treated by laparoscopic cholecystectomy (p=0 0017). Despite the persistence or de novo occurrence of symptoms, 111/117 patients (95%) considered that they had obtained overall symptomatic improvement by their surgical treatment and 110/118 (93%) were pleased with the end result regardless of the access used.
Annals of Saudi medicine
Laparoscopic cholecystectomy (LC) is now a common method of treating symptomatic gallstones, and it is increasingly being requested by the informed general public. Our aim was to evaluate the role of LC for cholelithiasis and to establish its outcome and the effect of gender on the results. Between September 1994 and June 1999, all patients who underwent LC for cholelithiasis were retrospectively reviewed. They were classified as having acute or chronic cholecystitis (AC or CC). There were 791 patients with CC (633 females, 158 males) and 204 patients with AC (124 females, 80 males). Conversion to open cholecystectomy was needed in 0.76% and 11.8% of the patients with CC and AC, respectively (P<0.00). Four percent of the female patients with AC needed conversion as compared to 23.8% in the males (P<0.00). The low conversion rate in CC limited gender comparison. Median operation time in the patients with CC was 53+/-16 minutes as compared to 74.5+/-35.7 minutes in those with AC...
Laparoscopic Cholecystectomy — Local Experience
Journal of Medical Sciences
Objectives: To evaluate the results of the first 100 cases of laparoscopic cholecystectomy in symptomatic gall stone disease in our unit. Material and Methods: It was a descriptive study, carried out in Surgical “A” Ward, Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan. This study was conducted from December 2006 to October 2008 including 100 patients who underwent laparoscopic cholecystectomy (LC). All patients with symptomatic gall stones were offered LC, excluding patients with CBD stones. Results: There were 100 patients with symptomatic gallstones, eighty-four (84%) females and Sixteen (16%) males. Eighty percent of the patients had chronic cholecystitis with gall stones. This included 5 patients with mucocele and 2 patients with carcinoma as an incidental finding. Twenty patients had acute cholecystitis. The mean operative time was 45.50 minutes. Mean hospital stay was 2.30 days (range 1.5 – 4 days). Our total conversion rate to open surgery was 4%. Complic...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020
Cholelithiasis is one of the most common surgical conditions requiring intervention worldwide. Since its introduction nearly four decades ago, laparoscopic cholecystectomy has become the gold standard of treatment for gallstone disease AIM: To critically evaluate our experience of laparoscopic cholecystectomy in a tertiary care centre of eastern India. MATERIALS AND METHODS: Hospital based observational study on 180 patients subjected to elective laparoscopic cholecystectomy with features of gall stone disease and meeting the inclusion and exclusion criteria. RESULTS: Our conversion rate of 10% is somewhat higher than that reported in any other series. This probably reflects that few of our surgeons are in their early learning curve. This can be reduced with the experience of the surgeons. A bile duct injury rate of 0.5% compares favourably with an incidence of 0-1% in several large series. Overall complication rate of 5.5% also compares favourably with an incidence of 1.6-8.6% in s...
Laparoscopic Cholecystectomy–An Audit at LUH/Jam
Rawal Medical Journal, 2011
To evaluate the results of laparoscopic cholecystectomy in symptomatic gall stones disease emphasizing on complications, morbidity and mortality. Patients and Methods This descriptive retrospective study was carried out in department of general surgery Liaquat University Hospital Jamshoro, Sind. Notes of all patients who underwent laparoscopic cholecystectomy in the department over an 18 month's period were reviewed. Demographics as well as details of cases of conversion to open operation and complications were noted on a designed performa. Data were analyzed using SPSS10. Results Out of 120 patients, 107 (85%) were females and 18 (15%) were males. The age ranged from 17 to 60 years (Mean 40 years). Six (9.9%) patients had bile leak, 3 (3.9%) developed port site wound infection, 3 (3.9%) developed collection in Morrison pouch and in 3 (3.9%) stones were recovered from epigastric port site wound. There were two cases of bile duct injury and one case of colonic injury. Conversion rate was10% and one patient died in post-operative period. Conclusion Though laparoscopic cholecystectomy is a safe and effective treatment for gall stone disease, our study showed relatively high complication rate. It may be because of learning curve, as it remains a procedure with the potentials for serious complications. Thus we need to have a structured training program involving stepwise progression of training. (Rawal Med J 2011;36:7-9).