Gallbladder Perforatıon Durıng Electıve Laparoscopıc Cholecystectomy: Incıdence, Rısk Factors and Outcome

Abstract

OBJECTIVE:This study aimed to reveal the risk factors and outcomes of gallbladder perforation (GP) during laparoscopic cholecystectomy.METHODS:Videotapes of all patients who underwent an elective cholecystectomy at our department were retrospectively analyzed, and the patients were divided into two groups based on the presence of GP. The possible risk factors and early outcomes were analyzed.RESULTS:In total, 664 patients [524 (78.9%) females, 49.7±13.4 years of age] were observed, and GP occurred in 240 (36.1%) patients, mostly while dissecting the gallbladder from its bed (n=197, 82.1%). GP was not recorded in the operation notes in 177 (73.8%) cases. Among the studied parameters, there was no significant risk factor for GP, except preoperatively elevated alanine transaminase level (p=0.005), but the sensitivity and specificity of this measure in predicting GP were 14.2% and 7.4%, respectively. The two groups had similar outcomes, but the operation time (35.4±17.5 vs 41.4±18.7 min, p=0.000) and incidence of drain use (25% vs 45.8%, p=0.000) increased in the GP group.CONCLUSION:The present study reveals that GP occurs in 36.1% of patients who undergo laparoscopic elective cholecystectomy, but it may not be recorded in most cases. We did not find any reliable risk factor that increases the possibility of GP. GP causes an increase in the operation time and incidence of drain use; however, the other outcomes were found to be similar in patients with GP and those without.

Intraoperative bile spillage is associated with worse survival in gallbladder adenocarcinoma

“…Documentation of bile spillage in the operative note is variable, but the placement of a surgical drain may represent a surrogate of spillage having occurred . We hypothesized that among patients who underwent initial cholecystectomy with incidentally found malignancy, intraoperative bile spillage or drain placement at cholecystectomy would be negatively associated with prognosis.…”

Dropped gallstones mimicking intraabdominal implants or tumor: A report of two cases

“…This technique is less invasive with rare post-operational complications [ 6 ]. Although complications of LC are infrequent, there is an increased risk of gallbladder perforation causing spilling gallstones into the intraperitoneal cavity [ 7 ]. Most patients with DGs remain asymptomatic and can be accidently found during CT scan imaging or surgery on the abdominal or pelvic region for another reason [ 3 , 5 ].…”

An Audit of Laparoscopic Cholecystectomy; at a Tertiary Care Hospital in Islamabad

“…It is less as compared to an international study that reported gallbladder perforation in 36.1% patients. 18 It is variably common in 10 to 30% of laparoscopic cholecystectomies, but it is usually not associated with any dreadful outcome, surgical site infection or post-operative collection. 19 Suction irrigation of the contaminated area is sufficient to address it.…”