Page 3 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
Nonbiliary Complications of Laparoscopic Cholecystectomy:

A Single-center Experience

1
Mohit Sharma , Rachhpal Singh 2

AbstrAct
Aim: Bile duct injury is an important complication of laparoscopic cholecystectomy. Nonbiliary injuries after laparoscopic cholecystectomy
can be fatal and source of considerable morbidity. In this study we intend to highlight the importance of nonbiliary complications sustained
during laparoscopic cholecystectomy and their outcome.
Materials and methods: The study is analysis of patients managed in our unit with post-laparoscopic cholecystectomy nonbiliary complications
from June 2010 to December 2018. Inclusion criteria—nonbiliary complications. Exclusion criteria—cases of bile duct injury, cases of surgical
site infection, trocar-site hernia.
Results: A total of nine patients with nonbiliary complications were managed. Mean age of the patients was 51.1 years (range 38–65). There
were five males and four females. Nonbiliary injuries were categorized into access-related and procedure-related complications. Three cases
(two colonics, one inferior vena cava) were access related. Six cases (five duodenal, one ileal) were procedure related.
Conclusion: Nonbiliary injuries are of significant severity. Adequate attention in creating pneumoperitoneum and meticulous dissection helps
in preventing complication. Timely detection and early therapeutic intervention can help reduce morbidity and mortality.
Keywords: Complications, Laparoscopic cholecystectomy, Nonbiliary injuries.
World Journal of Laparoscopic Surgery (2019): 10.5005/jp-journals-10033-1367

IntroductIon

Laparoscopic cholecystectomy is the standard of care for 1,2 Department of Surgery, Sri Guru Ram Das Institute of Medical
symptomatic cholelithiasis. The bile duct injury during laparoscopic Sciences and Research, Amritsar, Punjab, India
cholecystectomy is a well-known complication. The nonbiliary Corresponding Author: Mohit Sharma, Department of Surgery, Sri
injuries do occur with equally significant severity but tend to Guru Ram Das Institute of Medical Sciences and Research, Amritsar,
1
be underreported in literature. Nonbiliary complications can Punjab, India, Phone: +91 9814651788, e-mail: drmohit.gis@gmail.
be procedure related or access related. This study describes our com
experience in managing nonbiliary complications after laparoscopic How to cite this article: Sharma M, Singh R. Nonbiliary Complications
cholecystectomy. Various aspects like clinical presentation, of Laparoscopic Cholecystectomy: A Single-center Experience. World J
severity, management and outcome has been discussed. Our study Lap Surg 2019;12(2):49–52.
emphasis the need to prevent such complications, which are cause Source of support: Nil

of significant morbidity and mortality. Conflict of interest: None
MAterIAls And Methods

This study is retrospective analysis of prospectively collected data in our own unit (one colonic, one duodenal, one ileum), rest six cases
of patients with post-laparoscopic cholecystectomy complications. were referred from other hospitals.
The study included patients sustaining injury while operated in our The nonbiliary complications in decreasing order of frequency
hospital and also those who were operated in other hospitals and were duodenal (five cases), colonic (two cases), ileal (one case),
were referred to us once the injury was detected. Inclusion criteria— inferior vena cava (one case). Three cases (two colonics, one inferior
nonbiliary complications. Exclusion criteria—cases of bile duct injury, cava) were secondary to trocar insertion. Six cases (five duodenal,
cases of surgical site infection, trocar site hernia. From June 2010 to one ileal) occurred during dissection.
December 2018, a total of 60 patients with post-cholecystectomy
complications were managed in our unit. Of these 60 patients, 51 Access-related Injuries
were of biliary tract injury and 9 were nonbiliary injuries. Nonbiliary Colon Injury
injuries were further categorized into access-related complications, First case was 50 years old male. He sustained injury to transverse
procedure-related complications. Complete record of these nine colon during insertion of first trocar in a city nursing home. Our
patients were reviewed. Relevant points like difficulties encountered team was called upon as rescue surgeons. Immediate laparotomy
during surgery, conversion to laparotomy (done or not), clinical and repair of colon injury was done. He had uneventful outcome.
presentation, timing of referral, treatment and outcome were noted. Second case was 44 years old female. She had h/o abdominal
results sepsis following open hysterectomy in the past. Transverse colon
got injured during insertion of first trocar. Immediate laparotomy,
Mean age of the patients was 51.1 (38–65 years). There were five repair of colonic laceration was done. She had uneventful
males and four females. Three cases of nonbiliary injuries occurred outcome (Table 1).

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