Complications of laparoscopic cholecystectomy and their management

Of all the complications of laparoscopic cholectecystomy, bile duct injury and bile leak are the most serious complications. The purpose of this study is to present our data of incidence of the complications and our experience in the management of complications during and after laparoscopic cholecystectomy.

Retrospective study was performed on 348 patients, 102 males and 246 females with mean age of 52 years who underwent laparoscopic cholecystectomies during the period from 1 January 1996 to 31 December 1998 in the Department of Surgery, Rajavithi Hospital, Bangkok, Thailand. All complications were diagnosed and their management was recorded.

The complications included common bile duct injury in one case (0.29%) then we converted to exploratory laparotomy with cholecystectomy and Roux-en-Y choledochojejunostomy. One case that had cystic stump leakage (0.29%) and retained common bile duct stones was diagnosed later, we corrected by endoscopic retrograde cholangiopancreatography & ES, removed stones and placed a stent. One case had port wound infection (0.29%) which we treated by drainage and antibiotics. All of these had satisfactory results.

The complications of laparoscopic cholecystectomy can be prevented by adequate surgical experiences, carefulness and case selection. The results of their management also depend on the facilities and cooperation with the endoscopists.