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Vascular injury during laparoscopic cholecystectomy: An often-overlooked complication
Antonio Pesce1, Nicolò Fabbri2, Carlo Vittorio Feo2
1Department of Surgery, University of Ferrara, Azienda USL of Ferrara, Azienda USL of Ferrara, Lagosanto 44023, Ferrara, Italy. antonio.pesce@ausl.fe.it.
Insights
Vascular injuries during laparoscopic cholecystectomy are rare but serious complications. This review summarizes current evidence on their incidence and management, highlighting challenges in bleeding control.
Area of Science:
- Gastrointestinal Surgery
- Surgical Complications
- Vascular Injury Management
Background:
- Laparoscopic cholecystectomy is a common global surgical procedure.
- Vascular injuries are a significant cause of morbidity and mortality during this surgery.
- Controlling major bleeding laparoscopically can be challenging, particularly for less experienced surgeons.
Purpose of the Study:
- To provide an updated overview of vascular injury incidence during laparoscopic cholecystectomy.
- To review current scientific evidence on the surgical management of these injuries.
- To assess the impact of vascular lesions on conversion rates and mortality.
Main Methods:
- Systematic review of scientific literature.
- Analysis of reported incidence rates of vascular injuries.
- Evaluation of management strategies for bleeding complications.
- Assessment of conversion rates and mortality data.
Main Results:
- The incidence of conversion to open surgery due to vascular lesions ranges from 0% to 1.9%.
- The mortality rate associated with these vascular injuries is approximately 0.02%.
- Evidence highlights the technical difficulties in managing major bleeding during laparoscopy.
Conclusions:
- Vascular injuries, though infrequent, are critical complications of laparoscopic cholecystectomy.
- Effective management strategies are essential to minimize morbidity and mortality.
- Further research may focus on improving intraoperative bleeding control techniques.
Abstract:
Laparoscopic cholecystectomy is one of the most frequently performed procedures in gastrointestinal surgery worldwide. Bleeding complications due to vascular injuries represent an important cause of morbidity and mortality, especially when facing major bleeding during laparoscopy, where bleeding control can be technically challenging in inexperienced hands. Interestingly, the reported incidence rate of conversion to open surgery due to vascular lesions is approximately 0%-1.9%, with a mortality rate of approximately 0.02%. The primary aim of this article was to perform an up-to-date overview regarding the incidence and surgical management of vascular injuries during laparoscopic cholecystectomy according to the available scientific evidence.
