Complications of Laparoscopic Cholecystectomy

Summary: Fourteen papers clearly describing morbidity and mortality are evaluated to assess the frequency of major operative and postoperative accidents or complications associated with laparoscopic cholecystectomy and the key technical points important in the prevention of bile duct injury which is the most common operative complication during laparoscopic cholecystectomy. A total of 108, 612 laparoscopic cholecystectomies were performed in these series. Technical complications relating to the cause of death were encountered in 22 out of 49 cases (44.9%) and the mortality rate was 0.02%. The most common reason for conversion was difficult adhesions around the gallbladder, unclear anatomy of Carot's triangle and bile duct injury. Moreover bile duct injury was the most common technical complication, although injury to the major vessels and intestine led to higher mortality rates than common bile duct injury. Almost all authors have postulated in their papers that the majority of these major complications occured at institutions operating on less than 100 cases. These facts suggest that technical complications can be minimized by guidelines for prevention of operative injury, namely adequate training and experience in humans. In this paper, our technique was introduced and the importance of how to explore Carot's triangle is emphasized to prevent bile duct injury.