Page 6 - World Journal of Laparoscopic Surgery

Rooh-ul-Muqim et al

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dissection or adhesiolysis and they often remain undetected in a study from a single center by Vagenas K et al. Inspite of
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during operations. There was only one (0.28%) case of bowel the above mentioned complications the overall outcome was
injury in our study and it was recognized postoperatively when satisfactory, with better patient acceptance of the procedure.
the patient developed abdominal distension, rigidity and had a
toxic look. She was initially treated conservatively but CONCLUSIONS
laparotomy was performed on the 3rd day, where a perforation LC is one of the most frequently performed laparoscopic
in ileum with edematous gut covered with slough was found. operations. It has a low rate of mortality and morbidity. LC is a
So resection of affected segment with end to end anastomosis safe and effective procedure in almost all patients presenting
was performed. Intestinal ischemia and small bowel evisceration with cholelithiasis. Most of the complications are due to lack of
after LC have also been reported. 20,21 Bowel injury can be experience or knowledge of typical error.
prevented by trocar placement under direct vision and A rational selection of patients and proper preoperative
inspection of abdomen before withdrawing laparoscope. 5 work up as well as knowledge of possible complications, a low
In our study LC was converted to open surgery in 11(3.13%)
patients. In 3 cases the gallbladder was adherent, 5 cases of threshold for conversion, in combination with adequate training
makes this operation a safe procedure with favorable results.
vascular injury during LC where bleeding could not be controlled
with routine methods, and in 3 cases with disturbed anatomy, REFERENCES
Tayab M et al, in their study identified two preoperative risk
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Mortality was fortunately low in our series with only 2 cases procedure? Surg Endosc 2006;20(2):252-5.
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Three of our patients developed basal pneumonia and were study. Acta Chir Belg 2006;106(5).
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