Abdul Mannan Khan Rao, Abdul Ghafoor Dalwani, Champa Sushel, Ubedullah Shaikh.
Spilled bile and gallstones; the consequences during laparoscopic cholecystectomy: experience at Liaquat university hospital.
Professional Med J Jan ;23(08):964-9.

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

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