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Category: Volume 05 Issue 10 October 2017
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Title: Incidence of the Complications of Factors Predisposing to, and the rate of Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy

Author: Dr Mohammad Eqbal Ahmad

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.29

Abstract

Introduction: The first Laparoscopic cholecystectomy was performed by Erich Muhe in 1985 (Germany), followed by Mouret (1987 France)[1]. Laparoscopic cholecystectomy got accepted as a safe and better operation for G.B. stones in 1992 [2]. Laparoscopic cholecystectomy became popular in demand with time, because of its better cosmesis, minimal incisions, low morbidity and pain, short hospital stay, and recovery [3]. But it also had it's accompanying complications[5,14]. Thus many cases of Laparoscopic cholecystectomy were converted into a Laparotomy, when any of these complications developed.

Methods: Study of the incidence of complications, predisposing factors and the rate of conversion of Laparoscopic cholecystectomy into Open Laparotomy was done. 410 patients, who were put up for Laparoscopic cholecystectomy in Nalanda Medical College, Patna from March 14 - March 17 were observed.

Results: Randomized study of 410 patients of G.B. stones, put up for Laparoscopic cholecystectomy was done. Their median age was 40 yrs (range 16-64) and sex ratio was 403 F: 7 M. The common operative complications, their predisposing factors and the rate of conversion were observed.

Conclusion: 410 patients of G.B. stones, after proper clinical evaluation, Lab investigations and cardiological check-up were put up for Laparoscopic. cholecystectomy. The most common and dreadful complication was Bile Duct injury (common bile duct/common hepatic duct). It's incidence was 2.7% (11 patients) [11,12,13]. The next common complication was internal bleeding (cystric artery/liver bed / hepatic artery / aberrant vessels), seen in 1.7% (7 patients) [14,15]. Injury to intestines, liver, major vessels, due to electrocautery accidents during adhesiolysis or introduction of Veress / trocar for ports, was 0.9% (4 patients) [16]. Leakage of Bile/Spilled stones was seen in 0.7% (3 patients)[17]. Cardiac arrhythmia or hypotension due to pneumoperitoneum was seen in 0.7% (3 patients).

Keywords: Laparoscopic cholecystectomy (Lap. Chole./LC), C.B.D, Cystic artery, Hepatic artery, Murphy's Sign, Gall stones, common Hepatic D.

 

References

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Corresponding Author

Dr Mohammad Eqbal Ahmad

MBBS MS (Surg.) FAIS, D.A.

Associate Professor, Dept. of Surgery, Nalanda Medical College, Patna