Management and complications of intraoperative spillage of bile and gallstones during laparoscopic cholecystectomy: a single-center experience

Omar Mohammed Makhlouf, Gamal A. Eid, Ragai Sobhi Hanna
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Abstract

Background For symptomatic gallstones, laparoscopic cholecystectomy is the recommended surgical procedure. Aim and objectives This study's primary objectives were to identify the proper management of intraoperative spillage of bile and gallstones from the gallbladder throughout laparoscopic cholecystectomy, and to clarify the most common complications and how to deal with it. Patients and methods A total of 200 consecutive laparoscopic cholecystectomy cases from Assiut University Hospitals between August 2019 and August 2021 were included in the research. Results Gallbladder perforation was significantly occurring in acute cholecystitis. None of the patients underwent open procedure due to gallbladder perforation. Postoperative hospital stays in patients with gallbladder perforation ranges between 2 and 5 days with a mean value of 3.5 day. A follow-up was conducted after 1 week, 3 months, and 6 months. Conclusion Stones that have been dropped may cause morbidity. Even though they are very uncommon, serious consequences may happen and can complicate diagnoses. Gallstones that have spilled should be recovered as soon as feasible using a laparoscope. Because the risk of infective problems in such individuals may be significant, conversion to an open surgery should be taken into consideration if there are many gallstones that cannot be removed in the presence of bacteria.
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腹腔镜胆囊切除术中胆汁和胆结石溢漏的处理和并发症:单中心经验
背景对于有症状的胆结石,腹腔镜胆囊切除术是推荐的手术方法。目的和目的本研究的主要目的是探讨腹腔镜胆囊切除术中胆囊胆汁和结石的正确处理方法,并阐明最常见的并发症及其处理方法。患者和方法纳入2019年8月至2021年8月在阿西尤特大学附属医院连续行腹腔镜胆囊切除术的200例患者。结果急性胆囊炎患者胆囊穿孔发生率高。所有患者均未因胆囊穿孔而行开腹手术。胆囊穿孔患者术后住院时间为2 ~ 5天,平均3.5天。随访时间分别为1周、3个月、6个月。结论结石脱落可能引起并发症。尽管它们非常罕见,但可能会发生严重的后果,并使诊断复杂化。如果胆结石溢出,应尽快用腹腔镜检查。由于这些人感染问题的风险可能很大,如果有许多胆结石在细菌存在的情况下无法切除,则应考虑改用开放手术。
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