title: Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis.
abstract: OBJECTIVE
  The aim of this study was to evaluate the intraoperative and postoperative complications of laparoscopic cholecystectomy, as well as the frequency of conversions.
  
  
  METHODS
  Medical records of 740 patients who had laparoscopic cholecystectomy were analysed retrospectively. We evaluated patients for the presence of potential risk factors that could predict the development of complications such as age, gender, body mass index, white blood cell count and C-reactive protein (CRP), gallbladder ultrasonographic findings, and pathohistological analysis of removed gallbladders. The correlation between these risk factors was also analysed.
  
  
  RESULTS
  There were 97 (13.1%) intraoperative complications (IOC). Iatrogenic perforations of a gallbladder were the most common complication - 39 patients (5.27%). Among the postoperative complications (POC), the most common ones were bleeding from abdominal cavity 27 (3.64%), biliary duct leaks 14 (1.89%), and infection of the surgical wound 7 patients (0.94%). There were 29 conversions (3.91%). The presence of more than one complication was more common in males (OR = 2.95, CI 95%, 1.42-4.23, p < 0.001). An especially high incidence of complications was noted in patients with elevated white blood cell count (OR = 3.98, CI 95% 1.68-16.92, p < 0.01), and CRP (OR = 2.42, CI 95% 1.23-12.54, p < 0.01). The increased incidence of complications was noted in patients with ultrasonographic finding of gallbladder empyema and increased thickness of the gallbladder wall > 3 mm (OR = 4.63, CI 95% 1.56-17.33, p < 0.001), as well as in patients with acute cholecystitis that was confirmed by pathohistological analysis (OR = 1.75, CI 95% 2.39-16.46, p < 0.001).
  
  
  CONCLUSIONS
  Adopting laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of the hospital stay. It is important recognising IOC complications during the surgery so they are taken care of in a timely manner during the surgical intervention. Conversion should not be considered a complication.
authors.affiliation: Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
authors.forename: Miodrag
authors.initials: M
authors.lastname: Radunovic
authors.affiliation: Center for General and Digestive Surgery, Clinical Centre of Montenegro, Podgorica, Montenegro.
authors.forename: Ranko
authors.initials: R
authors.lastname: Lazovic
authors.affiliation: Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
authors.forename: Natasa
authors.initials: N
authors.lastname: Popovic
authors.affiliation: Clinic for General Surgery, General Hospital Berane, Berane, Montenegro.
authors.forename: Milorad
authors.initials: M
authors.lastname: Magdelinic
authors.affiliation: Clinic for Gastroenterology, Clinical Centre of Belgrade, University of Belgrade, Belgrade, Serbia.
authors.forename: Milutin
authors.initials: M
authors.lastname: Bulajic
authors.affiliation: General Medical Health, Primary Health Care Berane, Berane, Montenegro.
authors.forename: Lenka
authors.initials: L
authors.lastname: Radunovic
authors.affiliation: Urology and Nephrology Clinic, Clinical Centre of Montenegro, Podgorica, Montenegro.
authors.forename: Marko
authors.initials: M
authors.lastname: Vukovic
authors.affiliation: Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Radunovic
keywords: Laparoscopy; cholecystectomy; cholelithiasis