Journal of Surgery
Volume 3, Issue 4, August 2015, Pages: 39-43
Received: Jul. 12, 2015;
Accepted: Jul. 22, 2015;
Published: Jul. 31, 2015
Views 4162 Downloads 90
Mohamed Salah Abdelhamid, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Ahmed Mohamed Sadat, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Ayman Hamdi Abouleid, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Amr Mohamed Aly Mohamed, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Mahmoud Ahmed Negida, Surgery department, Kasr Elaini faculty of medicine, Cairo university, Cairo, Egypt
The wide acceptance of LC in the early 1990s was based on several case series rather than randomized controlled trials. Community awareness that a minimally invasive procedure could dramatically reduce postoperative pain and improve recuperation made it impractical to conduct trials that might have better refined the technique. This study was to recognize the actual complication risk associated with cholecystectomy. Included in the study were 1486 patients operated upon between Feb. 1999 and April. 2014. Open cholecystectomy done in 292 (19.6%) mostly in patients with contra-indications for laparoscopy, 1194 (80.4%) initiated laparoscopically, 1086[91%] completed laparoscopically and 108 (9%) converted to open procedure. There were eighteen (1.2%) patients with bile duct injury. One patient (0.3%) in the open procedure and seventeen (1.4%) in the laparoscopic procedure. Nine cases presented with intra-operative injury, two with early post operative jaundice, two with late post operative jaundice, five with post operative leak. The patients with recognized intra-operative injury were significantly not higher in the laparoscopic group of patients (P<0.3) than in the open procedure. The post operative jaundice was significantly high in the laparoscopic group of patients (P<0.045). The post operative leak was significantly higher in the laparoscopic group of patients than in the open procedure (P<0.028). In general post operative morbidity was high in the laparoscopic group of patients than in the open procedure (P<0.01). On the other hand, the post operative mortality were four times more in the open procedure and was statistically significant (P<0.04). Conclusion: The risk of complications after cholecystectomy was slightly higher than that found in literature; Laparoscopic cholecystectomy was associated with a higher incidence of CBD injuries, leak, jaundice and technical factors leading to failure to recognize injuries when they occur.
Mohamed Salah Abdelhamid,
Ahmed Mohamed Sadat,
Ayman Hamdi Abouleid,
Amr Mohamed Aly Mohamed,
Mahmoud Ahmed Negida,
Injuries Presentations in Laparoscopic Versus Open Cholecystectomy, Journal of Surgery.
Vol. 3, No. 4,
2015, pp. 39-43.
Zha Y, Chen XR, Luo D, et al The prevention of major bile duct injures in laparoscopic cholecystectomy: the experience with 13,000 patients in a single center,”Surgical Laparoscopy, Endoscopy and Percutaneous Techniques. 2010, vol. 20, no. 6, pp. 378–383.
Arche SB, Brown DW, Smith CD, et al “Bile duct injury during laparoscopic cholecystectomy: results of a national survey. Annals of Surgery,2001 vol. 234, no. 4, pp. 549–559.
Flum DR, Koepsell T, Heagerty P, et al.: Common bile duct injury during laparoscopic cholecystectomy and the use of intraoperative cholangiography. Arch Surg, 2001, 136 (11): 1287-92.
Gouma DJ and Go PM. Bile duct injury during laparoscopic and conventional cholecystectomy. J Am Coll Surg, 1994, 178:229-233.
Calvete J, Sabater L, Camps B, et al.: Bile duct injury during laparoscopic cholecystectomy: Myth or reality of the learning curve?. Surg Endosc, 2000, 14:608-11.
Jarnagin WR and Blumgart LH.: Operative repair of bile duct injuries involving the hepatic duct influence. Arch Surg, 1999, 134:769-75.
Branum G, Schmitt C, Baillie J, et al.: Management of major biliary complications after laparoscopic cholecystectomy. Ann Surg, 1993, 217:532-41.
West Cott CJ and Pappas TN.: Benign biliary strictures. In Cameron JL (ed). Current surgical therapy.: St. Louis, Missouri, Mosby, 1998, pp 425-434, 6th ed.
Swinscow TDV and Campell MJ.: Statistics at Square one. In TDV Swinscow (ed) Plymouth, Latimer trend & Company Ltd, 1996, pp 1-138 9th Ed.
Tokumura H, Rikiyama T, Harada N, et al.: Laparoscopic biliary surgery, Nippon Geka Gakkai Zasshi, 2002, 103 (10): 737-4.
Sandha GS, Bourke MJ, Haber GB, et al. Endoscopic therapy for bile leak based on a new classification: results in 207 patients,” Gastrointestinal Endoscopy 2004, vol. 60, no. 4, pp. 567–574.
Murr MM, Gigot JF, Nagorney DM et al.: Long term results of biliary reconstruction after laparoscopic bile duct injuries. Arch Surg, 1999, 134 (6): 604- 610.
Machado NO Biliary Complications Post Laparoscopic Cholecystectomy: Mechanism,Preventive Measures, and Approach to Management Diagnostic and Therapeutic Endoscopy 2011, Article ID 967017.
Buanes T, Wauge A, Mjaland O et al. Bile leak after cholecystectomy significance and treatment, Int surg, 1996, 81 (3):276-9.
Pineres G, Yama Kawa T, Kasugai H, et al.: Common bile duct stones, J hepato biliary Pancreat Surg, 1998, 5 (1): 97-103.
Giuliante F, Vellone M, Fianchini M and Nuzzo G. The surgical risk of laparoscopic cholecystectomy. Ann Ital Chris, 1998, 69 (6): 723-9.
Paczynski A, Koziarski T, Stanowski E, et al. Extrahepatic bile duct injury during laparoscopic cholecystectomy. Med sci Monit, 2002, 8 (6):438-40.
Mercado MA, Chan C, Orozco H, et al.: To stent or not to stent bilioenteric anastomosis after iatrogenic injury. Arch surg, 2002, 137 (1):60-63.
Mahatharadol V.: Bile duct injuries during laparoscopic cholecystectomy: Anaudit of 1522 cases. Hepatogastroenterology, 2004, 51(55): 12-40.
Heise M, Schmidt SC, adler A, et al.: Management of bile duct injury following laparoscopic cholecystectomy. Zentralbl Chir, 2003, 128 (11):944-51.
Ludwig K, Bernhardt J, Steffen H et al. Contribution of I.O.C. to the incidence and outcome of common bile duct injury during LC. Surg Endosc, 2002, 16 (7): 1098-104.