Laparoscopic cholecystectomy: incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations

Duca, S; Bălă, O; Al-Hajjar, Nadim; Iancu, Cornel; Puia, Cosmin; Munteanu, Diana; Graur, Florin

doi:10.1080/13651820310015293

Cited by 108 publications

(43 citation statements)

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“…The estimated rate of gallbladder perforation is 10-30%. Duca et al [8] reported that the incidence of iatrogenic perforation of the gallbladder was 1,517 (15.9%) out of 9,542 patients who underwent laparoscopic cholecystectomy. In our study, we report 39 (5.27%) iatrogenic perforations of the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

“…The most serious complications are associated with high mortality rate: injury of common bile duct with an incidence of 0.1-0.6% [5, 6], injuries of large blood vessels 0.04-1.22% depending on the study [7]. The most common complication is iatrogenic perforation of the gallbladder with spilt gallstones with an incidence of 10-30% [8]. Injuries during the laparoscopic cholecystectomy can be prevented by precise operative technique, clear visualisation of anatomical landmarks, and careful dissection of tissues.…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Introductionmentioning

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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“…Pericholecystitis makes laparoscopy challenging, changes the local anatomy, and increases the difficulty of identifying the Calot's triangle and common bile duct. Pericholecystitis can also predispose the patient to hemorrhage more easily from the gallbladder bed or cystic artery, and it causes an increased risk of gallbladder perforation and, thus, spillage of gallstones into the peritoneal cavity during dissection of the gallbladder 17. Thus, conversion rates in cases with AC were reported in the literature to reach up to 27.7% 18.…”

Section: Discussionmentioning

confidence: 99%

What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations

Genç

Sulaimanov

Cipe

et al. 2011

Clinics

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OBJECTIVE:Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy is still inevitable in certain cases. Knowledge of the rate and impact of the underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decided to review the rate and causes of conversion from laparoscopic to open cholecystectomy.METHOD:This study included all laparoscopic cholecystectomies due to gallstone disease undertaken from May 1999 to June 2010. The exclusion criteria were malignancy and/or existence of gallbladder polyps detected pathologically. Patient demographics, indications for cholecystectomy, concomitant diseases, and histories of previous abdominal surgery were collected. The rate of conversion to open cholecystectomy, the underlying reasons for conversion, and postoperative complications were also analyzed.RESULTS:Of 5382 patients for whom LC was attempted, 5164 were included this study. The overall rate of conversion to open cholecystectomy was 3.16% (163 patients). There were 84 male and 79 female patients; the mean age was 52.04 years (range: 26–85). The conversion rates in male and female patients were 5.6% and 2.2%, respectively (p<0.001). The most common reasons for conversion were severe adhesions caused by tissue inflammation (97 patients) and fibrosis of Calot's triangle (12 patients). The overall postoperative morbidity rate was found to be 16.3% in patients who were converted to open surgery.CONCLUSION:Male gender was found to be the only statistically significant risk factor for conversion in our series. LC can be safely performed with a conversion rate of less than 5% in all patient groups.

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“…This is followed by postoperative haemorrhage and sub-hepatic abscess formation, which occur in less than 0.1% of patients. 9 Conversion to an open procedure may be required in up to 2% of cases, usually because of post-inflammatory changes that impede laparoscopic identification of anatomy. Bowel injury is a potential complication of any laparoscopic procedure that can result from electrocautery or port-site trochar insertion.…”

Section: Discussionmentioning

confidence: 99%

Abdominal pain after surgery

Sheikh

Ahmad

Pallan

2017

BMJ

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Laparoscopic cholecystectomy: incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations

Cited by 108 publications

References 15 publications

Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations

Abdominal pain after surgery

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