Complications of Nonbiliary Laparoscopic Gastrointestinal Surgery: Radiologic Findings and Clinical Courses

Abstract

Purpose: To evaluate the radiological findings and clinical courses of the complications arising after nonbiliary laparoscopic gastrointestinal surgery (NLGS). Materials and Methods: We retrospectively reviewed the clinical records of 131 patients who underwent NLGS (83 cases involving colorectal surgery, 18 splenectomies, 14 appendectomies, ten adrenalectomies, three lumbar sympathectomies, two Duhamel ’s operation, and one peptic ulcer perforation repair) over a four-year period. Among these 131 patients, the findings of fifteen in whom postoperative complications were confirmed were analysed. The radiologic examinations these patients underwent included CT (n = 8), barium enema and fistulography (n = 4), ultrasonography (n = 3), ascending venography of the lower legs (n = 2), and penile Doppler sonography (n = 1). We evaluated the radiologic findings and clinical courses of early (within 2 weeks) and late (after 2 weeks) postoperative complications. Results: Sixteen cases of postoperative complications developed in fifteen patients ; in 14 (17%) after colorectal surgery and in one (6%) after splenectomy. Eleven of the sixteen cases (69%) involved early complications, consisting of an abscess in three, ischemic colitis in two, hemoperitoneum in one, perforation of the colon in one, pancreatitis in one, recto-vaginal fistula in one, deep vein thrombosis after colorectal surgery in one, and abscess after splenectomy in one. The remaining five cases (31%) involved late complications which developed after colorectal surgery, comprising anastomosic site stricture in two, abdominal wall (trocar site) metastasis in one, colo-cutaneous fistula in one, and impotence in one. Among the 16 cases involving postoperative complications, recto-vaginal fistula, colon perforation, and abdominal wall metastasis were treated by surgery, while the other thirteen cases were treated conservatively. Conclusion: Various postoperative complications develop after NLGS, with a higher rate of these being noted in cases involving colorectal surgery than in other cases.