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      Subcapsular liver haematoma as a complication of laparoscopic cholecystectomy

      case-report

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          Abstract

          Cholecystectomy is a common procedure for the treatment of symptomatic cholecystitis. A rare complication is the occurrence of subcapsular haematoma of the liver. In the literature, there are only a few case reports of this type. A 25-year-old woman was admitted to the Surgical Department for surgical treatment of cholecystitis. No complications were observed intra-operatively. On the first day after surgery, the patient manifested symptoms of hypovolaemic shock. The patient was qualified for surgical treatment in the mode of emergency surgery – a giant subcapsular haematoma was found. She was referred to the Clinic of General, Transplant and Liver Surgery of the Medical University of Warsaw for further treatment. This case shows the importance of monitoring the life parameters of patients who have undergone laparoscopic surgery due to symptomatic cholecystitis during the first day after surgery.

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          A prospective analysis of 1518 laparoscopic cholecystectomies. The Southern Surgeons Club.

          WC Meyers, M. Farouk, GD Branum (1991)
          The Southern Surgeons Club conducted a prospective study of 1518 patients who underwent laparoscopic cholecystectomy for treatment of gallbladder disease in order to evaluate the safety of this procedure. Seven hundred fifty-eight operations (49.9 percent) were performed at academic hospitals, and 760 (50.1 percent) at private hospitals. In 72 patients (4.7 percent) the operation was converted to conventional open cholecystectomy; the most common reason for the change was the inability to identify the anatomy of the gallbladder as a result of inflammation in the region of this organ. A total of 82 complications occurred in 78 (5.1 percent) of the patients; this is comparable with the rates of 6 to 21 percent that have been reported for conventional cholecystectomy. Overall, the most common complication was superficial infection of the site of insertion of the umbilical trocar. A total of seven injuries to the common bile duct or the hepatic duct occurred during the operation, for a rate of 0.5 percent. Four of the seven injuries were simple lacerations, which were repaired after conversion to conventional cholecystectomy. The incidence of bile-duct injury in the first 13 patients operated on by each surgical group was 2.2 percent, as compared with 0.1 percent for subsequent patients. No complications were attributed directly to either cautery or laser-surgical technique, and similar numbers of complications occurred in academic and private hospitals. The mean hospital stay for the entire group was 1.2 days (range, 6 hours to 30 days). The results of laparoscopic cholecystectomy compare favorably with those of conventional cholecystectomy with respect to mortality, complications, and length of hospital stay. A slightly higher incidence of biliary injury with the laparoscopic procedure is probably offset by the low incidence of other complications.
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            Laparoscopic cholecystectomy.

            Daniel G W Johnston (1992)
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              Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis.

              J Berlin, Peter J. Schwartz, P Malet … (1996)
              The purpose of this study was to perform a meta-analysis of large laparoscopic cholecystectomy case-series and compare results concerning complications, particularly bile duct injury, to those reported in open cholecystectomy case-series. Since the introduction of laparoscopic cholecystectomy in the United States, hundreds of reports about the technique have been published, many including statements about the advantages of laparoscopic cholecystectomy compared with those of open cholecystectomy. There is an unevenness in scope and quality of the studies. Nevertheless, enough data have accumulated from large series to permit analyses of data regarding some of the most important issues. Articles identified via a MEDLINE (the National Library of Medicine's computerized database) search were evaluated according to standard criteria. Data regarding the patient sample, study methods, and outcomes of cholecystectomy were abstracted and summarized across studies. Outcomes of laparoscopic cholecystectomy are examined for 78,747 patients reported on in 98 studies and compared with outcomes of open cholecystectomy for 12,973 patients reported on in 28 studies. Laparoscopic cholecystectomy appears to have a higher common bile duct injury rate and a lower mortality rate. Estimated rates of other types of complications after laparoscopic cholecystectomy generally were low. Most conversions followed operative discoveries (e.g., dense adhesions) and were not the result of injury. There is wide variability in the amount and type of data reported within any single study, and patient populations may not be comparable across studies. Except for a higher common bile duct injury rate, laparoscopic cholecystectomy appears to be at least as safe a procedure as that of open cholecystectomy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Wideochir Inne Tech Maloinwazyjne
                Journal ID (iso-abbrev): Wideochir Inne Tech Maloinwazyjne
                Journal ID (publisher-id): WIITM
                Title: Videosurgery and other Miniinvasive Techniques
                Publisher: Termedia Publishing House
                ISSN (Print): 1895-4588
                ISSN (Electronic): 2299-0054
                Publication date (Electronic): 09 June 2015
                Publication date (Print): July 2015
                Volume: 10
                Issue: 2
                Pages: 320-323
                Affiliations
                [1 ]Clinic of General, Oncological and Endocrine Surgery, Regional Polyclinical Hospital, Kielce, Poland
                [2 ]Department of Surgery and Surgical Nursing with Research Laboratory, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
                [3 ]Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
                Author notes
                Address for correspondence: Łukasz G. Nawacki MD, Clinic of General, Oncological and Endocrine Surgery, Regional Polyclinical Hospital, 45 Grunwaldzka St, 25-736 Kielce, Poland. phone: +48 606 994 460. e-mail: lukasznawacki@ 123456gmail.com
                Article
                Publisher ID: 25209
                DOI: 10.5114/wiitm.2015.52059
                PMC ID: 4520838
                SO-VID: 93b1e02b-5a88-4d90-9883-06bd9f549a14
                Copyright © Copyright © 2015 Sekcja Wideochirurgii TChP
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 January 2015
                Date revision received : 02 February 2015
                Date accepted : 22 February 2015
                Categories
                Subject: Case Report

                Keywords: complications,laparoscopic cholecystectomy,subcapsular haematoma
                Data availability:
                Keywords: complications, laparoscopic cholecystectomy, subcapsular haematoma

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