Laparoscopic cholecystectomy: early and late complications and their treatment

Shamiyeh, Andreas; Wayand, W.

doi:10.1007/s00423-004-0470-2

Cited by 133 publications

(116 citation statements)

References 97 publications

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“…Oozing from cirrhotic liver bed was the commonest cause. These are similar to what has been previously reported by some others [6,[20][21][22]. Half of these cases required conversion to control bleeding.…”

Section: Discussionsupporting

confidence: 91%

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“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

et al. 2013

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Laparoscopic cholecystectomy has revolutionized the management of symptomatic gallstone disease since its introduction more than 20 years ago. It has gained widespread acceptance and is presently the gold standard for its management. This large study spanned over last 10 years and includes prospective data on 950 elective cases of laparoscopic cholecystectomy since 2002. All cases were operated personally by the author in different teaching hospitals of West Bengal. The following were looked into: profiles of the patients including major comorbidities requiring special precautions, the frequency of "difficult cholecystectomies," conversion rate, and operative and postoperative complications. The results showed that 75 % of the patients were females. The mean age of the female patients was 35 years (range15-75), while that of the male patients was 42 (range 18-68). Thirty-two patients had major comorbidities which required special precautions in the perioperative period. Twenty-six percent of the cases were categorized as "difficult," and 6 % of the cases had to be converted to open procedure. Major complications occurred in 11 patients of which five had to be converted. Fiftyfive patients had port-site infection due to atypical mycobacteria species of which majority occurred in the last 1 year of the study. All of them responded to second-line antitubercular medications.

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Section: Discussionsupporting

confidence: 91%

“…The incidence of major bile duct injury of this series was 0.3 % (n=3) and is similar to the current reported incidence of major bile duct injuries which varies from 0.2 to 0.74 % [22][23][24][25][26]. We had two cases of lateral tear (both needed conversion for repair over T-tube) and one transection (had delayed reconstruction).…”

Section: Discussionsupporting

confidence: 84%

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

et al. 2013

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“…Açık kolesistektomi gibi LK'nin de peroperatif ve postoperatif komplikasyonları vardır. 11,12 Akut kolesistit olgularında LK esnasında açık cerrahiye geçme ve komplikasyon oranları artmaktadır. 3,13,14 Kesi yeri enfeksiyonları da LK'nin postoperatif minör komplikasyonları arasındadır.…”

Section: Discussionunclassified

Effects of endobag usage on port site infections in acute cholecystitis

Gırgın¹

2012

Dicle Med J

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Objectives: To find out the usage of endo-bag technique whether has an effect on port site infection in which the gallbladder is removed out within the patients of laparoscopic cholecystectomy for acute cholecystitis. Materials and methods:A total of 30 cases with acute cholecystitis underwent laparoscopic cholecystectomy by the same surgeon in Fırat University Medical School Hospital were evaluated. Endobag was used in 15 patients and 15 patients were included as control group. All the patients were observed in terms of port site infection after removal of gallbladder in postoperative period.Results: There were no wound infection in which endobag was used, but 3 patients of the control group had port site infection. Conclusion:There were no significant effect of using endo-bag among acute cholcystitis patients underwent laparoscopic chelcystectomy on the port site infection which gall bladder is removed out.

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“…They are used not only in iatrogenic injury treatment, but also in liver transplantation in biliary anastomosis. There are contradictory reports on effectiveness of different biliary iatrogenic injury reconstruction methods (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47). Most authors prefer hepaticojejunostomy because of fewer postoperative anastomosis strictures (15,19,(30)(31)(32)(33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

“…Disturbances within the hormonal axis of the alimentary tract occur, such as prolonged after-meal hyperinsulinemia and hypergastrynemia, which leads to a rise in the production of gastric juice and pH change; digestive gastric and duodenal ulcerations are also more frequently reported as a consequence during the postoperative period. Other authors prefer end-to-end ductal anastomosis because it guarantees the most physiological bile flow into the duodenum and allows the anastomosis endoscopic control (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). The hepaticojejunostomies (49 patients) and end-to-end ductal anastomoses (45 patients) were the most frequently performed methods in the presented material.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Iatrogenic Biliary Injuries - Early Complications

Jabłońska¹,

Lampe²,

Lekstan³

et al. 2008

Polish Journal of Surgery

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The aim of the study was the analysis of early complications following different methods of surgical treatment for iatrogenic biliary injury (IBI). Material and methods. From January 1990 to March 2005, 138 patients with iatrogenic biliary injuries were operated on in the Department of Gastrointestinal Surgery of Silesian Medical University in Katowice. The most frequent iatrogenic biliary injuries were caused by open and laparoscopic cholecystectomy. Clinical symptoms in patients included the following: pain, jaundice, pruritus, nausea, vomitus and cholangitis signs. The following diagnostic examinations were performed before surgical procedures: laboratory investigations and radiological examinations -including ultrasonography of the abdominal cavity, cholangiography, endoscopic retrograde cholangiopancreatography, computed tomography and magnetic resonance-cholangiography. The level of biliary injury was classified according to Bismuth. The following reconstruction methods were performed: Roux-Y hepaticojejunostomy in 49 patients, endto-end ductal anastomosis in 45 patients, jejunal interposition hepaticoduodenostomy in 27 patients, bile duct plastic reconstruction in 6 patients, choledochoduodenostomy in 2 patients and other methods in 8 patients.Results. The mean duration of hospitalization was 31 days. The mean duration of operation was 4.5 hours. Early complications were observed in 22 (16%) patients. The following early complications were noted: bile collection in 11 patients, intra-abdominal abscess in 4, wound infection in 13, peritonitis in 2, cholangitis in 2, eventeration in 1, pneumonia in 7 and acute circulatory insufficiency in 3 patients. Seven (5%) early re-operations were performed: 2 due to biliary-enteric anastomosis dehiscence, 1 due to eventeration, and 4 due to bile collection or intra-abdominal abscess. Three (2%) hospital deaths were noted: 1 due to due acute circulatory insufficiency, 1 due to liver necrosis and acute respiratory and circulatory insufficiency, and 1 due to biliary-enteric anastomosis dehiscence, bile collection, peritonitis, and acute circulatory and respiratory insufficiency. Conclusions. Surgical reconstructions of iatrogenic biliary injuries are procedures that require maximal precision and knowledge of different methods of reconstruction of biliary tract continuity. The choice of the method depends on the situation in the operation area. In treatment centers experienced in iatrogenic biliary injuries, early complications occur in 16% of surgical patients. Mortality does not exceed 2% of surgical patients.

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Laparoscopic cholecystectomy: early and late complications and their treatment

Abstract: Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe laparosopic cholecystectomy.

Cited by 133 publications

References 97 publications

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

Effects of endobag usage on port site infections in acute cholecystitis

Surgical Treatment of Iatrogenic Biliary Injuries - Early Complications

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