SPILLED BILE AND GALLSTONES

THE CONSEQUENCES DURING LAPAROSCOPIC CHOLECYSTECTOMY: EXPERIENCE AT LIAQUAT UNIVERSITY HOSPITAL

Abstract

Objectives: Intra-peritoneal bile leak and gallstones spillage is a common
event, during laparoscopic cholecystectomy. Some time it is not possible to retrieve all spilt
gallstones, these unretrieved intra-peritoneal gallstones, initially considered harmless, with time
a number of complications have been reported. Our aim was to study, factors predisposing to
gallbladder perforation during laparoscopic cholecystectomy, and the incidence and adverse
consequences of intra-peritoneal spilt gallstone. Period: November 2008 to December 2011.
Setting: Liaquat University Hospital were studied. Method: Patients who underwent successful
laparoscopic cholecystectomy for biliary colic and cholelitiasis. Patients who had intraperitoneal
bile and gallstones spillage during laparoscopic cholecystectomy were follow up
for long period, and all patients studied for risk of perforation and complications. Results:
1038 patient underwent successful laparoscopic cholecystectomy, among them in 812(78.23%)
patient intact gallbladder were removed, and in 226 (21.77%) patient gallbladder perforation
occurred. Patients had gallbladder perforations in 129(12.43) patients only bile leak was noted,
and in 97(9.34%) patients bile and gallstones spillage occurred. Conclusion: We concluded
the outcome and incidence of serious complications after intra-operative spillage of gallstones
and bile, during laparoscopic cholecystectomy, is low and avoidable.