Laparoscopic cholecystectomy: Imaging of complications and normal postoperative CT appearance

Abstract

Six patients underwent imaging studies to evaluate complications related to laparoscopic cholecystectomy. In addition, computed tomography (CT) of the abdomen and pelvis was performed on six patients 3-5 days after uncomplicated laparoscopic cholecystectomy in order to further clarify the normal postoperative CT appearance in these patients. Complications included ureteral laceration with periureteric hematoma and ureteroperitoneal fistula, hepatic artery pseudoaneurysm, hepatic laceration, retained common bile duct stone, bile leak, and biloma of the abdominal wall. At 3-5 days following uncomplicated laparoscopic cholecystectomy, typical CT findings include fluid density in the gallbladder fossa, a very small amount of pelvic fluid, and small densities within the subcutaneous fat at the expected sites of trocar insertion.

Hepatic Artery Angiography and Embolization for Hemobilia Following Laparoscopic Cholecystectomy

“…CT and Doppler ultrasound can also be used in diagnosis [15] but, in experienced hands, angiography is quick, safe, accurate and allows immediate treatment by embolization. If celiac angiography fails to identify a source of bleeding, selective right hepatic angiography should be performed.…”

Postlaparoscopic Iatrogenic Pseudoaneurysms of the Arteries of the Peritoneal and Retroperitoneal Space

“…However, CT imaging is recommended in all postlaparoscopy patients who present clinical evidence of a complication. 9 In the majority of the reports (70.8%), the management of these rare complications was embolization of the pseudoaneurysms (using coils, gel-foam, or other thrombotic materials). In selected.…”

Recurrent abdominal abscess secondary to a dropped laparoscopic clip: CT imaging

“…Even with this high rate of soilage, only a handful of complications have been reported as being related to spilled gallstones, such as intraabdominal abscess and small bowel obstruction [1]. Other reported complications of laparoscopic cholecystectomy include ureteral laceration, hepatic laceration, hepatic artery pseudoaneurysm, retained common duct stone, and bile leak [3,4]. It has been acknowledged that surgical clips are often dropped during laparoscopic cholecystectomy.…”