Complications of Laparoscopic Cholecystectomy -An Analysis of the Cases Reported to Japanese Medical Societies-

Taizo Kimura

First Department of Surgery, Hamamatsu University School of Medicine

To evaluate complications of laparoscopic cholecystectomy, the complications reported to eight Japanese medical societies by 53 hospitals including ours were analyzed. Bile duct, vascular, bowel and diaphragm injuries occurred in 1.09, 0.18, 0.10 and 0.12% of 6,800 laparoscopic cholecystectomies, respectively. The common bile duct was the site of bile duct injury in 69% of the cases. Most of the bile duct injuries (77%) were due to disorientation of the anatomy or an electric burn, while most of the vascular injuries (91%) were due to puncture by the first trocar, and all of the diaphragm injuries were due to an electric burn. To prevent these complications, it seems important to start dissection of the cyscic duct after skeletonizing the neck of the gallbladder and to avoid use of electrocautery near the bile duct and diaphragm. Furthermore, it is recommended to perform intraoperative cholangiography and to adopt open laparoscopy.

Key words
laparoscopic cholecystectomy, complication, prevention

Reprint requests
Taizo Kimura First Department of Surgery, Hamamatsu University School of Medicine
3600 Handa-cho, Hamamatsu, 431-31 JAPAN

Accepted
May 11, 1994

To read the PDF file you will need Abobe Reader installed on your computer.