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Updated: Aug 18, 2026

Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
Published on: March 28, 2025
[Special complications of cholecystectomy performed by micro- and modern mini-laparotomy]
I Rozsos1, J Ferenczy, D Afshin
1I. Sebészeti Osztály, Kaposi Mór Megyei Kórház, Kaposvár.
Abstract:
There is no data on the special complications of micro (less than 4 cm incision) and modern mini laparotomy cholecystectomies (4.1-6 cm incision). Out of 710 non selected patients, 643 micro laparotomy cholecystectomies were performed and 61 modern mini laparotomies due to choledocholithiasis. On three occasions, conventional mini (6.1-10 cm) laparotomy was performed and in another three, conventional laparotomy (over 10 cm incision) was executed. Intraoperative bleeding was encountered in 15 cases (2.1%) while accidental hepatic duct clipping occurred in one case (0.1%). Damage to the bile duct did not occur in any case reported. Postoperative bleeding was reported in 8 cases (1.1%) and delayed bile leakage was reported in 10 cases (1.4%). Special complications reported as a result of pathological alteration in the bile tract as follows: Intraoperative bleeding encountered during simple cholecystectomy-1% but cholecystectomy due to obstructive cholecystitis 3.8%, also caused by intraoperative bleeding. Delayed bile leakage in simple cholecystectomy was not observed, but after cholecystectomy for obstructive cholecystitis it encountered in 3.4%. Special complications resulted in four early reoperations (0.5%). Two other patients were re-operated within three weeks, independent of special complications. The percentage of both intra and postoperative complication was significantly higher in obstructive cholecystitis with an operative delay of 11 or more days.
Insights
Micro and mini laparotomy cholecystectomies show low complication rates. Obstructive cholecystitis cases, however, present higher risks for bleeding and bile leakage, necessitating careful surgical consideration.
Area of Science:
- Minimally invasive surgical techniques
- Gastrointestinal surgery
- Hepatobiliary surgery
Context:
- Limited data exists on complications specific to micro ( < 4 cm) and modern mini (4.1-6 cm) laparotomy cholecystectomies.
- This study analyzes complications in a large cohort undergoing various cholecystectomy incision sizes.
Purpose:
- To evaluate the incidence and types of special complications associated with micro and modern mini laparotomy cholecystectomies.
- To compare complication rates between simple and obstructive cholecystitis cases.
Summary:
- Out of 710 patients, 643 underwent micro and 61 modern mini laparotomy cholecystectomies.
- Overall complication rates were low, including intraoperative bleeding (2.1%) and postoperative bleeding (1.1%).
- Obstructive cholecystitis cases showed significantly higher rates of intraoperative bleeding (3.8%) and delayed bile leakage (3.4%), leading to increased reoperations (0.5%).
Impact:
- Findings highlight the safety of micro and mini laparotomy cholecystectomies for general cholecystectomy.
- Identifies obstructive cholecystitis as a critical factor increasing surgical complication risk.
- Informs surgical decision-making and patient counseling regarding potential risks.

