Biliary mishaps in laparoscopic cholecystectomy.
OBJECTIVE
To determine the incidence and types of biliary complications following laparoscopic cholecystectomy in our patients.


METHODS
The clinical records of one hundred and fifty-five patients undergoing laparoscopic cholecystectomy were reviewed.


RESULTS
Five patients developed biliary mishaps. The overall incidence of biliary complications was 3.2% (5/155). The incidence of major complications was 1.9% (3/155) and the incidence of minor biliary complications was 1.2% (2/155). In 3 out of 5 patients the mishap was attributed to developmental anomalies. Dense pericholecystic adhesions and cystic duct blow out were responsible for biliary complications in one patient each. Bilioenteric anastomosis was performed in two patients and restoration of continuity of the common hepatic duct over a T-tube was done in one patient. Side hole in an accessory duct was repaired over a T-tube and cystic duct blow out was managed with endoscopic biliary drainage alone.


CONCLUSIONS
A high index of suspicion of developmental anomalies, cautions approach in difficult cases and readiness to consider conversion to open cholecystectomy are recommended to reduce the incidence of biliary complications in laparoscopic cholecystectomy.
Verma
G R
GR
Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012. grverma@glide.net.in
Bose
S M
SM
Singh
Rajinder
R
Singh
Gurpreet
G
D000328:Adult; D001659:Biliary Tract / Q000293:injuries*; D001660:Biliary Tract Diseases / Q000209:etiology*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*