Consequences of Spilt Gallstones During Laparoscopic Cholecystectomy

Virupaksha, Suvi

doi:10.1007/s12262-012-0600-y

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…Perforation of a gallbladder with gallstones spilt into the peritoneal cavity is a frequent complication, especially when associated with acute cholecystitis and larger gallstones [14, 17, 24]. Z’graggen K et al [17] published a prospective study on 10,174 patients and showed that 1.4% complications were due to spilt gallstones.…”

Section: Discussionmentioning

confidence: 99%

Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

Lazovic

Popović

Magdelinic³

et al. 2016

Open Access Maced J Med Sci

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AIM:The aim of this study was to evaluate the intraoperative and postoperative complications of laparoscopic cholecystectomy, as well as the frequency of conversions.MATERIAL AND METHODS:Medical records of 740 patients who had laparoscopic cholecystectomy were analysed retrospectively. We evaluated patients for the presence of potential risk factors that could predict the development of complications such as age, gender, body mass index, white blood cell count and C-reactive protein (CRP), gallbladder ultrasonographic findings, and pathohistological analysis of removed gallbladders. The correlation between these risk factors was also analysed.RESULTS:There were 97 (13.1%) intraoperative complications (IOC). Iatrogenic perforations of a gallbladder were the most common complication - 39 patients (5.27%). Among the postoperative complications (POC), the most common ones were bleeding from abdominal cavity 27 (3.64%), biliary duct leaks 14 (1.89%), and infection of the surgical wound 7 patients (0.94%). There were 29 conversions (3.91%). The presence of more than one complication was more common in males (OR = 2.95, CI 95%, 1.42-4.23, p < 0.001). An especially high incidence of complications was noted in patients with elevated white blood cell count (OR = 3.98, CI 95% 1.68-16.92, p < 0.01), and CRP (OR = 2.42, CI 95% 1.23-12.54, p < 0.01). The increased incidence of complications was noted in patients with ultrasonographic finding of gallbladder empyema and increased thickness of the gallbladder wall > 3 mm (OR = 4.63, CI 95% 1.56-17.33, p < 0.001), as well as in patients with acute cholecystitis that was confirmed by pathohistological analysis (OR = 1.75, CI 95% 2.39-16.46, p < 0.001).CONCLUSION:Adopting laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of the hospital stay. It is important recognising IOC complications during the surgery so they are taken care of in a timely manner during the surgical intervention. Conversion should not be considered a complication.

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Section: Discussionmentioning

confidence: 99%

Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

Lazovic

Popović

Magdelinic³

et al. 2016

Open Access Maced J Med Sci

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“…Перфорация желчного пузыря с изливанием в брюшную полость желчными камнями является частым осложнением, особенно при остром холецистите, при наличии крупных желчных камней и спаек, а также чаще встречается у мужчин, у пациентов с ожирением и пожилых людей [14]. Утечка конкрементов может происходить во время рассечения желчного пузыря из ложа печени, разрыва с помощью зажимных щипцов или во время извлечения желчного пузыря через один из участков порта [14]. Z'graggen K опубликовал исследование на 10 174 пациентах и показали, что 1,4 % осложнений были вызваны пролитыми желчными камнями [15].…”

Section: результаты исследования и их обсуждениеunclassified

Iatrogenic Complications During Laparoscopic Cholecystectomy and Their Prevention

Almasud¹,

Osmanova²,

Mihaylichenko³

2020

НО МН (SR MS)

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Хирургическая патология желчных протоков является одним из распространенных заболеваний в экономически развитых странах, по поводу которых в мире выполняется несколько миллионов операций в год. В последнее время в широкой клинической практике стали использоваться минимально инвазивные оперативные вмешательства. Лапароскопическая холецистэктомия стала золотым стандартом лечения симптоматических заболеваний желчного пузыря. Однако применение лапароскопической холецистэктомии ввело новый спектр сопутствующих осложнений при травмах желчного пузыря, желчных протоков и различных геморрагических осложнениях, отличающихся от осложнений при открытой холецистэктомии, одними из которых являются поступление желчи в брюшную полость и перитонит, стриктуры желчных протоков, рецидивирующий холангит, сепсис, вторичный билиарный цирроз печени, печеночная недостаточность и, наконец, может привести к смерти пациента при несвоевременном их обнаружении и предотвращении. Раннее выявление и лечение этих осложнений позволит свести к минимуму потенциально неблагоприятные последствия. Осложнения лапароскопической холецистэктомии могут быть предотвращены использованием правильной хирургической техники и правильным выбором случая. Постоянный анализ ошибок и осложнений, описанных в данной статье, в перспективе позволит снизить их количество до минимальных цифр. ключевые слова: лапароскопическая холецистэктомия, геморрагические осложнения, билиарные осложнения, ятрогенные осложнения, профилактика осложнений

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“…Recent data suggest that this can be done by the retrieval of stones and either mopping the gallbladder fossa with surgical gauze or by an interoperative wash to evaluate the spilled content. International data suggest that the complications can range from 2.3% and 7% [ 8 ]. This incidence doubles when stones are not removed [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Dry Mopping vs. Saline Irrigation of Gallbladder Fossa After Bile Spillage During Laparoscopic Cholecystectomy: Randomized Control Trial

Bhatti¹,

Ahmad²

2021

Cureus

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Introduction The laparoscopic approach, as compared to open cholecystectomy, is still considered the gold standard, despite a higher incidence of micro insults. The most common approach to treat spilled biliary contents and lost stones in laparoscopic cholecystectomy is the retrieval of the stone through an open approach, or laparoscopically, ending with a peritoneal wash and aspiration. Material and methods We conducted a double-blinded randomized controlled trial. In the study group, patients with bile spillage during cholecystectomy underwent suction of all spilled bile and evacuation of all visible stones followed by dry mopping of the gallbladder fossa with gauze swab through an epigastric port. In the control group, after suction of all bile and visible stones, the gallbladder fossa was washed with 250 ml of saline, and fluid was aspirated through the epigastric port. Results Sixty patients were included (30 patients in each group), 71.6% were female and the rest were male. There was a statistically significant difference in pain scores between the two groups (p=0.001). The dry mopping group had lower pain scores as compared to the other group postoperatively. The incidence of the intraabdominal collection in both groups are statistically insignificant, however, port site infection and intraabdominal collection are higher in the control group (irrigation group). Conclusion Although there is not much literature on the best approach to biliary spillage in laparoscopic cholecystectomy. We believe that dry mopping had better postoperative patient outcome as compared to the saline wash.

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Consequences of Spilt Gallstones During Laparoscopic Cholecystectomy

Cited by 10 publications

References 23 publications

Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

Iatrogenic Complications During Laparoscopic Cholecystectomy and Their Prevention

Dry Mopping vs. Saline Irrigation of Gallbladder Fossa After Bile Spillage During Laparoscopic Cholecystectomy: Randomized Control Trial

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