Complications of Laparoscopic Cholecystectomy

Abstract

Objective: To evaluate the complications of laparoscopiccholecystectomy in symptomatic and asymptomatic cholecystolithiasis.Design and duration: Prospective study from 1st June 2005 to 30thJune 2007.Setting: Surgical �D� Unit, Khyber Teaching Hospital, Peshawar.Patients: All patients with cholecystolithiasis who had laparoscopiccholecystectomy.Methodology: All patients with gallstone disease both symptomaticand asymptomatic, of both sexes and any age were evaluated by history,examination and investigations and the data collected on a proforma.Patients with chronic liver disease or those deferred by the anesthetistwere excluded from the study. All patients underwent laparoscopiccholecystotomy, outcome and complications were analyzed.Result: 351 patients underwent laparoscopic cholecystectomy in thestudy period. 314 (89.46%) were females and 37 (10.54%) were males.Common age group was between 21-40 years (56.41%), bleeding wasthe commonest complication, occurring from trocar site in 35 (9.97%),vascular injury in Callot�s triangle in 57 (16.23%) and liver bed in 39(11.11%) cases. Spilled gallstones occurred in 37 (10.54%), biliaryleak in 14 (3.98%) including CBD injury in 2 cases. Port site infectionwas 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.Late complications CBD stricture and Port hernia were seen in 5(1.42%) and 3(0.85%) cases respectively. Mortality was only 2(0.56%).Conclusion: LC is a safe and effective procedure in almost all patientswith cholelithiasis. Proper preoperative work up, knowledge of possiblecomplications and adequate training makes this operation a safeprocedure with favorable result and lesser complications.