Bleeding complications in laparoscopic cholecystectomy: Incidence, mechanisms, prevention and management

Kaushik, Robin

doi:10.4103/0972-9941.68579

Cited by 68 publications

(59 citation statements)

References 21 publications

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“…The most important patientrelated risk factors of operative bleeding are acute cholecystitis, liver cirrhosis, previous abdominal surgery, peritoneal adhesion and anatomical abnormalities [18][19][20]. Our data came in agreement with these results as we observed that operative bleeding was 7.84% in patients with acute cholecystitis, fibrotic gall bladder and extensive peritoneal adhesion.…”

Section: Discussionsupporting

confidence: 90%

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Preoperative Prediction of the Difficulty of Laparoscopic Cholecystectomy

Saber¹

2015

J Surg Surgical Res

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Introduction: Preoperative complexity estimation helps deciding whether to proceed with a minimally invasive approach, perform an open procedure or make a referral to a more experienced surgeon. Laparoscopic cholecystectomy outcome is particularly affected by the presence and severity of inflammation, advancing age, male sex and greater BMI. Objective:The aim was to trace outcome of laparoscopic cholecystectomy with difficult situation. Patients and Methods:A total of 204 patients with difficult situation cholecystitis were enrolled to this study. The triad of clinical examination, laboratory data and ultrasound study was preformed for all patients. The primary end point of the study was operative outcome and the second end point was morbidity related to surgery. Results:The operative outcome was represented as operative bleeding and conversion to open surgery while the postoperative outcome was biliary leakage and port site infection. The total score for each patient with conversion to open surgery or with postoperative biliary leakage was between 6-10 points indicating difficult surgical approach according to the scoring system. Conclusion:Preoperative prediction of risk factors of conversion or difficulty is an important point for operative planning and the high risk patients may be informed accordingly. cholecystectomy in our patients with difficult situation according to the recently published scoring system [6].

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Section: Discussionsupporting

confidence: 90%

“…Incidence of operative bleeding in many series was up to 10% with an average figure of 2% [18]. The most important patientrelated risk factors of operative bleeding are acute cholecystitis, liver cirrhosis, previous abdominal surgery, peritoneal adhesion and anatomical abnormalities [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Prediction of the Difficulty of Laparoscopic Cholecystectomy

Saber¹

2015

J Surg Surgical Res

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“…19 The incidence of significant bleeding requiring conversion and that of wound infection was also not statistically different in the two groups. Over all morbidity rate was 8.3% in males and 6% in females and the difference was not statistically significant (p-value >0.5).…”

Section: Discussionmentioning

confidence: 75%

A study of impact of gender on operative findings and outcome in patients undergoing laparoscopic cholecystectomy

Kumar¹,

Kumar²,

Verma³

et al. 2016

Int Surg J

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Background: Gallstone disease (GSD) is a prevalent health problem around the globe and the treatment of choice for symptomatic GSD is laparoscopic cholecystectomy (LC). There are many factors that influence the operative findings, conversion rates and the outcome of surgery. Male gender has been considered by some to be an adverse factor in this regard. Through this study we intend to find out the role of gender in the operative findings and outcome of laparoscopic cholecystectomy.Methods: All the patients undergoing laparoscopic cholecystectomy at SMI Hospital, Dehradun during one year period were included in the study with certain exceptions. The details of clinical presentation, operative findings and conversion rates, duration of surgery and peri-operative complications were recorded separately for male and female patients and compared.Results: A total of 402 patients were included in the study. 72 (17.9%) were male and 330 (82%) were female. The mean duration of surgery was significantly greater in the male group (66 min) as compared to female group (60.5 min). The rate of conversion to open surgery was not significantly different in the two groups. There was no significant difference in frequencies of complications in the two groups.Conclusions: Gender has little role as far as overall morbidity and conversion to open surgery are concerned in patients undergoing laparoscopic cholecystectomy.

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“…[22][23][24][25] which have mostly been proven not to be major concerns. [26][27][28] However, laparoscopic application to liver surgery was relatively delayed due to the complexity of the operation. Recently, two consecutive international consensus meetings made several points.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Laparoscopic Left Lateral Sectionectomy vs. Open Left Lateral Sectionectomy: Single Center Experience

Kim

Koh

Cho

et al. 2017

J Minim Invasive Surg

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Purpose: Laparoscopic surgery has become the mainstream surgical operation due to its stability and feasibility. Even for liver surgery, the laparoscopic approach has become an integral procedure. According to the recent international consensus meeting on laparoscopic liver surgery, laparoscopic left lateral sectionectomy (LLS) might be a new standard of care for left lateral surgical lesions. This study was designed to compare open LLS to laparoscopic LLS. Methods: In total, 82 patients who had undergone LLS at Chonnam National University HwasunHospital between 2008 and 2015 were enrolled in this study. Among them, 59 patients underwent open LLS and 23 underwent laparoscopic LLS. These two groups were compared according to general characteristics and operative outcomes. Results:The data analysis results showed that laparoscopic liver resection is superior to open liver resection in terms of the amount of bleeding during the operation and the duration of hospital stay. There was no statistical difference between the two groups in terms of operation time (p value=0.747). The amount of bleeding during the operation was 145.5±149.4 ml on average for the laparoscopic group and 320±243.8 ml on average for the open group (p value=0.005). The mean duration of hospital stay was 10.7±5.8 days for the laparoscopic surgery group and 12.2±5.1 days for the open surgery group (p value=0.003). Conclusion:This study showed that laparoscopic LLS is safe and feasible, because it involves less blood loss and a shorter hospital stay. For left lateral lesions, laparoscopic LLS might be the first option to be considered.

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Bleeding complications in laparoscopic cholecystectomy: Incidence, mechanisms, prevention and management

Cited by 68 publications

References 21 publications

Preoperative Prediction of the Difficulty of Laparoscopic Cholecystectomy

Preoperative Prediction of the Difficulty of Laparoscopic Cholecystectomy

A study of impact of gender on operative findings and outcome in patients undergoing laparoscopic cholecystectomy

Outcomes of Laparoscopic Left Lateral Sectionectomy vs. Open Left Lateral Sectionectomy: Single Center Experience

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