LAPAROSCOPIC CHOLECYSTECTOMY: DIFFICULTIES & COMPLICATIONS IN 300 CASES
|Full paper||Not Available|
Laparoscopic cholecystectomy (LC) was attempted in 300 consecutive patients. 292 patients (97.3%) presented on an elective basis for symptomatic chronic calcular cholecystitis, and the remaining 8 patients (2.7%) were admitted for acute cholecystitis. 26 (8.6%) were obese and 6 patients have upper or right paramedian scars after previous abdominal operations. These difficulties required some precautions during insertion of trocars and meticulous technique for acute cases. Careful identification of cystic artery anomalies by combination of sharp and blunt dissection reduced the frequency of bile duct injuries which were recorded to be 0.7% (2 patients). These two patients were among the group required conversion to open cholecystectomy; 19 patients (63%). No mortality was reported in the included patients while the morbidity rate reached to 5.7% (17 patients). It is concluded that LC can be performed safely even in some difficult cases, and its complications can be prevented by proper patient selection according to surgeon experience and by election to convert to open cholecystectomy than to be forced to do so.