Traps of laparoscopic cholecystectomy – our experience

Introduction: Laparoscopic cholecystectomy in treatment of cholelithiasis is the most common operation in videosurgery techniques. Although the techniques are still improving, there are many complications, some of which are specific for this method. For this reason sharing experience between the centres should be regularly described in professional literature. Aim: Evaluation of intraoperative and postoperative complications related to laparoscopic treatment of gallstone disease in our experience. Materials and methods: Intraoperative and postoperative complications in a group of 2098 patients qualified for laparoscopic cholecystectomy were analysed. Acute cholecystitis in 342 cases was the indication for surgical treatment. Results: The average age of patients was 49.8 years (from 16 to 81); among them 79% were women. Average hospital stay was 4.3 days (from 2 to 31). There were 176 cases of complications or situations where the surgeon decided to convert the technique of operation to classical cholecystectomy, but only in 0.15% of cases was the decision due to intraoperative complications and resulted from our initial period of using the laparoscopic method; the others were decisions of the surgeons at the beginning of operation. The most complications occurred during the operation and were possible to be treated in that time. These were: haemorrhage from the gallbladder artery or its branch (0.9%), haemorrhage from the gallbladder chamber (0.9%), haemorrhage from the location of the “umbilical” trocar (1.1%), haemorrhage from injured intercostal artery (0.05%), perforation of the gallbladder and spillage of concretions (1.3%), leakage of bile from the gallbladder chamber (0.2%). Laparotomy was needed only in 2 cases of early postoperative complications (these were complications related to bleeding). There were 17 cases of periumbilical hernia as a late postoperative complication. Conclusions: There were low numbers of complications that needed surgical treatment late in time, but there were three cases of serious injury of biliary ducts that required reoperation. No deaths were recorded within the perioperative period.