Perforation and spillage of gallstones during laparoscopic cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy, second most common abdominal operation in general surgery practice, has some advantages over conventional cholecystectomy. Such as better cosmetic results, less postoperative pain, and a shorter hospital stay. and an earlier return to daily activities. Gallbladder perforation (GP) has been reported to occur at a high rate of 6% - 40% Cases.

Aim: Purpose of this study to investigates the frequency of incidence of gall bladder perforations and spillage of gallstones because Gallbladder perforation causes an increase in the operation time and incidence of drain use. This study would help to develop future planning for the prevention of gallbladder perforation.

Methodology: This audit study was conducted in patients that come to operation theater complex for surgical procedure of laparoscopic cholecystectomy in Shalamar hospital Lahore. The sample size was 89 patients. The data had been collected, entered and exported to SPSS model 27 for analysis. Chi-square and Fischer exact test was used to analyze the data. P-value of 0.05 was considered as significant.

Results:  Among 89 patients 21(23.6%) were males and 68(76.4%) were females. Gallbladder perforation was observed in 21(23.6%) cases. In which 4(19%) were males and 17(25%) were females. The spillage of gallstones occurred in 15(16.9%) cases. In which 2(9.5%) were males 13(19.1%) were females. The complications of Bile Leakage 6(6.7%). Bleeding 2(2.2%), Abdominal abscess 6(6.7%), and Umbilical trocar site infection 3(3.4%) were seen. No significant association was found between risk factors and Gallbladder perforation.  

Conclusions: This study reveals, frequency of gallbladder perforation was significant among the treated patients. We were unable to identify any reliable risk factor which increases the probability of gallbladder perforation.

Key words: Gallstone laparoscopic Cholecystectomy