Page 3 - World Journal of Laparoscopic Surgery

Complications of Laparoscopic Cholecystectomy
World Journal of Laparoscopic Surgery, January-April 2008;1(1):1-5
Complications of

Laparoscopic Cholecystectomy

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1 Rooh-ul-Muqim, Qutab-e-Alam Jan, Mohammad Zarin, Mehmud Aurangzaib, Aziz Wazir
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1 Assistant Professor of Surgery, Surgical—D-Unit, KTH Peshawar
2 Senior Registrar, Surgical—A-Unit , KTH Peshawar
3 Senior Registrar, Surgical—D-Unit, KTH Peshawar,
4 Associate Professor, Surgical—D-Unit, KTH Peshawar
5 Professor Incharge, Surgical—D-Unit, KTH Peshawar
Correspondence: Rooh-ul-Muqim
Assistant Professor Surgery, Surgical—D-Unit, Khyber Teaching Hospital, KTH Peshawar
House # 185, St. No. S, Sector J-2, Phase II, Hayatabad Peshawar

Abstract INTRODUCTION
Objective: To evaluate the complications of laparoscopic Laparoscopic cholecystectomy (LC) has replaced open surgery
cholecystectomy in symptomatic and asymptomatic cholecysto- in the treatment of cholecystolithiasis. It is now considered the
lithiasis. first option and has become the “gold standard” in treating
1,2
Design and duration: Prospective study from 1st June 2005 to 30th benign gallbladder disease. The risk of intraoperative injury
June 2007. during laparoscopic cholecystectomy is higher than in open
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cholecystectomy. It has been anticipated that this will
Setting: Surgical “D” Unit, Khyber Teaching Hospital, Peshawar.
diminish with increasing surgeon experience in the use of LC. 3
Patients: All patients with cholecystolithiasis who had laparoscopic In USA approximately one million patients are newly diagnosed
cholecystectomy. annually with gall disease and approximately 600,000 operations
Methodology: All patients with gallstone disease both symptomatic are performed a year more than 75% of them by laparoscopy. 5
and asymptomatic, of both sexes and any age were evaluated by history, Laparoscopic cholecystectomy offers the patients the
examination and investigations and the data collected on a proforma. advantages of minimal invasive surgery. However with the
Patients with chronic liver disease or those deferred by the anesthetist widespread acceptance of LC the spectrum of complications in
were excluded from the study. All patients underwent laparoscopic gallstone surgery has changed. The intraoperative
cholecystotomy, outcome and complications were analyzed. complications of LC like bowel and vascular injury (trocar site),

Result: 351 patients underwent laparoscopic cholecystectomy in the biliary leak and bile duct injuries decrease with the passage of
study period. 314 (89.46%) were females and 37 (10.54%) were males. time, because of increased experience of the surgeons, popularity
Common age group was between 21-40 years (56.41%), bleeding was of the procedure and introduction of new instruments.
the commonest complication, occurring from trocar site in 35 (9.97%), This study presents a 2-years experience of laparoscopic
vascular injury in Callot’s triangle in 57 (16.23%) and liver bed in 39 cholecystectomy with the aim to evaluate the complications of
(11.11%) cases. Spilled gallstones occurred in 37 (10.54%), biliary laparoscopic cholecystectomy in cholecystolithiasis, both
leak in 14 (3.98%) including CBD injury in 2 cases. Port site infection symptomatic and asymptomatic.
was seen in 17 (4.84%), while bowel injury was seen in only one
(0.28%) cases. Conversion to open surgery was in 11 (3.13%) cases. MATERIAL AND METHODS
Late complications CBD stricture and Port hernia were seen in 5
(1.42%) and 3(0.85%) cases respectively. Mortality was only 2 This prospective study was carried out in surgical-D-Unit of
(0.56%). Khyber Teaching Hospital Peshawar from 1st June 2005 to 30th
Conclusion: LC is a safe and effective procedure in almost all patients June 2007. Data was collected on a proforma designed to include
with cholelithiasis. Proper preoperative work up, knowledge of possible demographic information, history, examination findings,
complications and adequate training makes this operation a safe investigations, operation technique and procedure,
procedure with favorable result and lesser complications. complications and their management as well as follow up. All
patients undergoing laparoscopic cholecystectomy were
Keywords: Laparoscopic cholecystectomy, complications, outcome,
gallstones. included while patients deferred by the anesthetist or
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