DOI: http://dx.doi.org/10.18203/2349-2902.isj20192973

Case series of 200 laparoscopic cholecystectomy, their intra-operative finding and post-operative complication

Sovat Lal Ahirwar

Abstract


Background: In the current era of laparoscopic procedure, laparoscopic cholecystectomy are most commonly performed surgery all over the world. The biliary tract injury by laparoscopic cholecystectomy has been found to be higher than open cholecystectomy. So adequate recognition and awareness of anatomical abnormalities of encounter during laparoscopic cholecystectomy can decrease the morbidity and mortality related to surgery.

Methods: It is prospective study including 200 patients based on intra-operative finding and their postoperative complication in Bhopal Memorial Hospital and research centre Bhopal, during period of Jan 2017 to Jan 2019.

Results: In 200 cases 154 were Female and 46 were male. Mucocele of gallbladder in 22 cases, pyocele of gall-bladder in 7 cases. Gallbladder wall thickened and fibrosis in 13 cases. Gallbladder with duodenal fistula in 1case, gall bladder with colon and gall bladder with stomach fistula both in 1 case, and gall bladder with stomach fistula in 1 case. In one case there is absent gall bladder but patient havingCBD stone. Cystic artery cant separated from cystic duct and clipped along with cystic duct in 16 cases. In 3 cases there were gall bladder malignancy two were suspected intra-operatively and procedure abandoned other one after post lap cholecystectomy, confirm with biopsy report. Two cases develop post op incisional hernia. In 8 cases lap cholecystectomy converted into open cholecystectomy.

Conclusions: This case series of laparoscopic cholecystectomy will help surgeons to be aware of such intra-operative finding and complication, so as to prevent undesirable outcome.


Keywords


Cystic duct, Cystic artery, Laparoscopic cholecystectomy

Full Text:

PDF

References


Macfadyen Jr BV, Vecchio R, Ricardo AE. Bile duct injury after laparoscopic cholecystectomy. Surg Endosc 1998;12:315-21.

Mahatharadol V. Bile duct injuries during laparoscopic cholecystectomy: An audit of 1522 cases. Hepatogastroenterol. 2004;51:12.

Schmidt SC, Settmacher U, Langrehr JM. Management and outcome of patients with combined bile duct and hepatic arterial injuries after laparoscopic cholecystectomy. Surg. 2004;135:613-8.

Specht MJ. Calot's triangle [Letter]. JAMA. 1967;200:1186.

Pappas TN, Posther KE: Acute cholecystitis. In: Cameron JL, ed. Current Surgical Therapy, 8th ed. Philadelphia: Mosby; 2004: 385-392.

Shamiyeh A, Wayand W. Laparoscopic cholecystectomy: Early and late complications and their treatment. Langenbecks Arch Surg. 2004;389:164-71.

Z'graggen K, Wehrli H, Metzger A. Complications of laparoscopic cholecystectomy. Surg Endosc. 1998;12:1303-10.

Regoly-Merei J, Ihasz M, Szeberin Z. Biliary tract complications in laparoscopic cholecystectomy. Surg Endosc. 1998;12:294-300.

Soper NJ. Effect of nonbiliary problems on laparoscopic cholecystectomy. Am J Surg. 1993;165:522-6.

Lo CM, Liu CL, Lai EC. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998;227:461-4.

Chen AY, Daley J, Pappas TN. Growing use of laparoscopic cholecystectomy in the national Veterans Affairs Surgical Risk Study: Effect on volume, patient selection, and selected outcomes. Ann Surg. 1998;227:12-24.

Rutledge D, Jones D, Rege R. Consequences of delay in surgical treatment of biliary disease. Am J Surg. 2000;180:466-9.

Uchiyama K, Onishi H, Tani M. Timing of cholecystectomy for acute cholecystitis with cholecystolithiasis. Hepatogastroenterol. 2004;51:346-8.

Roslyn JJ, Binns GS, Hughes EX. Open cholecystectomy: A contemporary analysis of 42,474 patients. Ann Surg. 1993;218:219-29.

Morgenstern L, Wong L, Berci G: Twelve hundred open cholecystectomies before the laparoscopic era: A standard for comparison. Arch Surg. 1992;127:400-4.

Soper NJ. Effect of nonbiliary problems on laparoscopic cholecystectomy. Am J Surg. 1993;165:522-6.

Neuhaus H, Feussner H. Ungeheuer. Prospective evaluation of the use of endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy. Endoscopy. 1992;24:745.

Esber E, Sherman S. The interface of endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Gastrointest Endosc Clin N Am. 1996;6:57.

Hugh TB, Kelly TB. Laparoscopic anatomy of the cystic artery. Am J Surg. 1992;163:593.

Khaitan L, Apelgren K, Hunter J. A report on the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) Outcomes Initiative: what have we learned and what is its potential? Surg Endosc. 2003;17:365.

Kowalewski K, Todd EF. Carcinoma of the gallbladder induced in hamsters by insertion of cholesterol pellets and feeding dimethylnitrosamine. Proc Soc Exp Biol Med. 1971;136:482-9.