Incidence of Biliary Leakage and Spilled Gallstones in Laparoscopic Cholecystectomy

Abstract

Gallstones (GS) are a major health problem worldwide. Its prevalence in the adult population of the United States is about 10%, which reaches 30% in the age group over 70 years. The incidence of GS in Pakistan is 15%, which represents 22% of surgical admissions. Laparoscopic cholecystectomy is accepted worldwide as the 1st line of treatment for symptomatic gallstone disease. Objective: To assess the occurrence of spilled gallstones and biliary leakage during laparoscopic cholecystectomy. Methods: A prospective descriptive study was conducted in the Surgical Department of Hayatabad Medical Complex Peshawar for six months duration from 15 June, 2021 to 15 November, 2021. Patients with gallstones were hospitalized via outpatient department. They were admitted for the analysis after procurement of knowledgeable consent in written form. All related investigations have been performed. Eligibility for anesthesia was assessed using the ASA scoring system. Patients endured laparoscopic cholecystectomy and the data was secured in a previously designed form. Results: During the period under analysis, 150 patients underwent laparoscopic cholecystectomy. 40.10 years ± 10.74 years was the mean age. The main complication in 18 cases (12%) where the largest number of stones were removed during surgery, was gallstone spillage from whom 3 (17.6%) patients were 19-29 years old, 8 patients (47.1%) were 30-40 years old, 5 (29.4%) patients were 41-50 years old and 1 patient (5.9%) was 51-60 years old and 1 (5.9%) patient were 61-70 years old. The rate of gallstone spillage was 7 (4.7%) for men and 11 (7.3%) for women. Biliary leakage occurred in 5 patients (3.3%) aged 30-40 years and in 1 (0.7%) of patients aged 41-50 years. Conclusion: Laparoscopic cholecystectomy is effective and safe method in our environment and brings improved outcomes in the hands of specialists