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Laparoscopic Cholecystectomy Complications - Our Experience
( Zhanar Kaidar ),( Erlan Sultangereev ),( Galymzhan Aubakirov ),( Zhazylbek Abdin ),( Asset Elemesov ),( Bazylbek Zhakiev ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: The aim is to analysis of the complications of laparoscopic cholecystectomy (LCE). Methods: Retrospectively analyzed 1412 LCE, which performed between 2009-2016. The indication to LCE was gallbladder stone (GS). 914 patients (64,7%) had GS with acute cholecystitis, 498 (45,3%) - chronic cholecystitis. Average age was 49,5±0,37 year. Woman - 81,4% (n=1150), man - 18,6% (n=262). Results: Complications occurred in 31 (2,2%) patients. The conversion was in 46 (3,26%) cases. Cause of conversions: infiltrative process of HDL - 34 cases (73,9%), bile duct injure - 5 (10,8%), liver abscess detection - 1 (2,1%), atypical cystic artery - 1 (2,1%), bleeding - 4 (8,6%), duodenum injure - 1 (2,1%). Early postoperative complications: bile leakage - 9 patients (in 5 patients stopped own), bleeding - 2, sub-hepatic infiltrate - 4, choleperitonitis - 3. Three patients had relaparoscopy due to bile leakage from cystic duct stump (1 case) and bleeding from cystic artery (2). Reasons of early 4 laparotomy were postoperative bleeding - 1 patient, bile leakage - 3 cases. Abdominal wall wound inflammatory complications were 1,9% (after LCH for acute cholecystites). After LCE 1 patient died due to pulmonary artery tromboemboly. Those, after LCE complications causes were: Inflammatory tissue infiltration in the subhepatic area with acute cholecystitis, adhesions and scarring in chronic process hinders the visualization of anatomical structures. The atypical anatomical structure of the extrahepatic bile ducts and liver vessels. Risk factors of complications include older age, obesity, long duration of GB disease. Conclusions: The study of the causes of intraoperative and early postoperative complications of LCE can eliminate risk factors that contribute to it development. Careful comprehensive preoperative examination to the prediction of the complexity of surgical intervention will improve immediate results of all LCE.