Short Term Effect of Spilled Bile & Gallstone During Laproscopic Cholecystectomy on Clinical Outcome

Accidental gallbladder perforation during laparoscopic cholecystectomy is on the rise because of increased attempts at minimally invasive surgery. There have been a number of studies attempting to determine the effect of spilled bile and gallstones on the clinical outcomes, but the results are still conflicting.

This is a randomized prospective study to evaluate the short term effect of spilled bile and gallstones on clinical outcome in patients who sustained a gallbladder perforation.

This study was carried out in Department of General Surgery at Alsader Teaching Hospital and Al-Fayhaa General Hospital in basrah, Iraq from September 2015 to October 2017 included 396 patients of either gender and different age groups who underwent laparoscopic cholecystectomy.

Sixty-six patients sustained a gallbladder perforation (16.7%). and it primarily occurred during dissection of the hepatic fossa in 42 patients (63.6%). The mean operative time and duration of postoperative hospitalization were longer in the perforated group (P=0.015 and P=0.001). Visual analog scale scores for pain on the first and second postoperative days were higher in the perforated group (P=0.009 and P=0.034). Complications such as ileus and port site infection developed more frequently in patients with a gallbladder perforation (P=0.001 and P=0.004).

Accidental gallbladder perforation can cause more postoperative pain, increase operative time, ileus, and port site infection, which consequently increases the total duration of hospitalization, undermining the advantages of Laparoscopic cholecystectomy. based on these interesting results, surgeons should make every effort to prevent gallbladder perforation by performing careful and precise dissection during the operation.