Vol. 5, Issue 1, Part F (2021)

Material and Methods: This was a retrospectively analysed study conducted in the Department of General Surgery, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh, India, from December 2018 to November 2019. 100 patients who were diagnosed with cholelithiasis and had laparoscopic cholecystectomy were included in this study. We analysed the type and frequency of intraoperative and postoperative complications, as well as factors that increase the risk for development of complications. We noted causes and incidence of conversions and the way they resolved. We noted gender, age, body mass index (BMI), white blood cell count, and level of C-reactive protein (CRP), preoperative ultrasonographic findings, Patho histological findings of the surgically removed gallbladder, as well as their correlation with the occurrence of complications.

Results: Out of the 100 patients in the study, 68 were female (68%), and 32 were male (32%). The most common complications noted were: iatrogenic perforations of the gallbladder- 5 (5%), bleeding from the tissues adjacent to the gallbladder 3 (3%), gallstones spilt into the peritoneal cavity 2 (2%). Intraoperative bleeding from the cystic artery occurred in 1 (1%), bleeding from the port in 1 (1%) and bleeding from the ligaments of the liver in 1 patients (1%). The transection of the common bile duct, a major complication, occurred in only one patient (1%). The most common postoperative complications were: bleeding from the abdominal cavity more than 100 ml/24h (in 3 patients or 3%), bile leaks through the drain > 50-100 ml/24h (2 patients, or 2%). In addition, the ultrasonographic findings of empyema, gangrene of the gallbladder wall, and increased gallbladder wall thickness > 3 mm (group II) is a significant predictor of complications and conversion (OR = 4.92, 95% CI 1.61-18.13, p< 0.001). Patho histologic analysis of the surgically extracted gallbladder with the diagnosis of acute cholecystitis was also the significant predictor for complications and conversion (OR 1.82, 95% CI 2.52-16.66, P< 0.001).

Conclusion: the laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of the hospital stay.