Complications of laparoscopic cholecystectomy

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Since its introduction in the 1980s, laparoscopic cholecystectomy has been the choice of patients, as well as expert surgeons like Laparoscopic Surgeon in Lahore because of its shorter recovery period, lower incidence of complications and morbidity. However, like any surgical procedures, there are certain complications associated with this as well. Read on to know what the complications of laparoscopic cholecystectomy are:

What is laparoscopic cholecystectomy?

Cholecystectomy refers to the procedure of gall bladder removal for patients with biliary disease, such as, gall stones in the gall bladder or the bile duct, large gall bladder polyps, inflammation of the gall bladder, pancreatic inflammation due to gall stones, and cancer of the gall bladder.

Cholecystectomy is one of the commonest procedures performed on the surgical floor. It can be performed through a large incision on the abdomen called open cholecystectomy, or it may be performed through a small incision and insertion of a thin tube with a camera on its end, known as laparoscopic cholecystectomy. The latter is minimally invasive and has many benefits.

What are the benefits of laparoscopic cholecystectomy?

Laparoscopic cholecystectomy offers a smaller incision compared to open cholecystectomy. Thus, after the surgery laparoscopic cholecystectomy is less painful and has a smaller scar. The recovery period of laparoscopic cholecystectomy is smaller than the open procedure, and these patients return quicker to their regular activities.

What are the complications of laparoscopic cholecystectomy?

Despite the advantages of laparoscopic cholecystectomy, there are some complications associated with it. These include:

Infection:

Because cutting open of the viscera is involved, there is risk of infection and entrance of disease-causing microorganisms in the body. This infection may be internal, or of the wound, in case of poor post-operative care. Signs of infection include: redness, fever, pain and leakage of pus from the wound.

Bleeding

Bleeding is more often a post-operative complication; however, it may arise intra-operatively as well. The latter is more common when the surgery is performed with a poor technique, or when there are some anatomical variabilities.

Injury to the bile duct

There are chances that the bile duct may be injured when the gallbladder is removed. If incurred intraoperatively, the surgeon is able to repair the wound on the table. However, in cases where they are discovered after the procedure, additional surgery may be needed for repair. Injury to the bile duct may lead to conversion of laparoscopic cholecystectomy into an open cholecystectomy.

Leakage of bile

When gall bladder is removed during laparoscopic cholecystectomy, special clips are used to seal the bile duct. However, bile can still leak sometimes in the abdomen leading to swelling in the abdomen, nausea, pain in the stomach, and fever. If the pain does not settle on its own, surgery may be needed to drain it. The incidence of bile leakage is less than 1 percent.

Injury to the bowels and blood vessels

Handling of the sharp instruments intraabdominally can occasionally damage the bowels, located in close proximity to the gallbladder and the vascular bed. These injuries are recognized intraoperatively, and the surgeon is able to repair them easily. However, it may convert the laparoscopic cholecystectomy into an open cholecystectomy, particularly if the blood vessels are injured and the source of bleeding is not visible through the laparoscope. In case the injuries are noticed postoperatively, they warrant an explorative laparotomy to repair the damaged region.

Deep vein thrombosis

This is a post-surgical complication associated with immobility and clot formation. Deep vein thrombosis occurs when clots form in the veins of the legs, and when they dislodge from their primary site, they may embolize to structures such as the lungs and cause pulmonary embolism. Pulmonary embolism is a potentially-fatal complication as it blocks the blood flow to the lung. The complications of laparoscopic cholecystectomy are rare, and the chances are further reduced when experts like Laparoscopic Surgeon in Karachi perform it.