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Early Complications of Laparoscopic Cholecystectomy: A Prospective Study


Taufiqul Haque1, Ahamaduz Zaman2


Background: Laparoscopic cholecystectomy (LC) has been established as the gold standard procedure for the symptomatic gallstone disease since 1996. It offers the patients faster return to work, lesser postoperative pain and much improved cosmetic results as compared to open procedure. Aims: to evaluate the spectrum of complications of laparoscopic cholecystectomy, methods of identification of complications and appropriate measures to be taken to combat these complications. Methods: An observational prospective type study was done in Shaheed Monsur Ali Medical College Hospital and in certain Private Hospital settings at Uttara, Dhaka during January 2011 to December 2017. In total 300 patients were selected irrespective of age and sex, on the basis of having symptomatic gallstone disease in the form of biliary colic and chronic cholecystitis. LC performed by using standard Phillips laparoscopic procedure. Per operative and post operative complications were measured. Results: Laparoscopic cholecystectomy was done in 296 (98.67%) cases and in 4 (1.33%) cases conversion was needed. Per operative complication rate was 45 (15%). Among these, one case (0.33%) developed major complication, i.e. injury to the common bile duct and conversion was done. Other complications were perforation of gallbladder with spillage of bile in 17 (5.67%) cases, spillage of stones in 6 (2%) cases, total per operative bleeding in 17 (5.67%) cases, which were due to cystic artery bleeding in 2 (0.67%) cases, bleeding from gallbladder bed in 10 (3.33%) cases, trocar site bleeding in 5 (1.67%) cases, bile oozing from the gallbladder bed in 2 (0.67%) cases, which continued through drain up to second postoperative day. Postoperative complications rate was 32 (12%), where 2 (0.67%) developed major postoperative complications and laparotomy were done to manage these complications. Postoperative wound infection occurred in 9 (3 %) cases. Conclusion: Complication rate of laparoscopic cholecystectomy is not higher than that for open cholecystectomy. Most of the complications are preventable if LC is performed following strict precautions, especially optimum exposure of Calot's triangle, judicious use of diathermy and safe clip application and the use of peroperative cholangiography can prevent late diagnosis of bile duct injury.

Key words: Laparoscopy, Cholecystectomy, Cholelithiasis

Issue: Vol. 6 No. 2 (2020)

Publish Date: Jun 07, 2022