The effect of the degree of histologic inflammation on gallbladder perforation during laparoscopic cholecystectomy.
OBJECTIVE
Laparoscopic cholecystectomy (LC) is the gold standard operation for the treatment of symptomatic gallstones. Intraoperative gallbladder perforation is a common complication encountered during the surgery. The purpose of this study was to identify the effects of inflammation on gallbladder perforation during LC.


METHODS
Between July 1997 and March 2003, 509 patients underwent LC for symptomatic gallstone disease at the Department of Surgery at Vakif Gureba Training Hospital. Data were collected retrospectively. Patients with and without gallbladder perforation were compared in terms of gender, age, anatomic difficulty, experience of the surgeon, omental and other organ adhesions to the gallbladder, and the findings of inflammation on the resected gallbladder.


RESULTS
Intraoperative gallbladder perforation occurred in 85 patients (16.6%). Although no differences were found between the perforated and nonperforated groups regarding age, gender, and chronic inflammation on the resected gallbladder, there were significant differences in terms of acute inflammation, anatomical difficulty, experience of the surgeon, and omental and organ adhesions.


CONCLUSIONS
Acute inflammation, degree of anatomic difficulty, the experience of the surgeon, and omental or other organ adhesions were associated with gallbladder perforation during LC.
Bas
Gurhan
G
Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey. gurhanbas@yahoo.com
Eryilmaz
Ramazan
R
Akcakaya
Adem
A
Daldal
Emin
E
Alimoglu
Orhan
O
Okan
Ismail
I
Sahin
Mustafa
M
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002983:Clinical Competence; D005260:Female; D005704:Gallbladder / Q000293:injuries* / Q000473:pathology*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000473:pathology