Long-term consequences of intraoperative spillage of bile and gallstones during laparoscopic cholecystectomy

Rice, D.C., Memon, M.A., Jamison, R.L., Agnessi, T., Ilstrup, D., Bannon, M.B., Farnell, M.B., Grant, C.S., Sarr, M.G., Thompson, G.B., Van Heerden, J.A., Zietlow, S.P. and Donohue, J.H. (1997) Long-term consequences of intraoperative spillage of bile and gallstones during laparoscopic cholecystectomy. Journal of Gastrointestinal Surgery, 1 1: 85-91. doi:10.1007/s11605-006-0014-x


Author Rice, D.C.
Memon, M.A.
Jamison, R.L.
Agnessi, T.
Ilstrup, D.
Bannon, M.B.
Farnell, M.B.
Grant, C.S.
Sarr, M.G.
Thompson, G.B.
Van Heerden, J.A.
Zietlow, S.P.
Donohue, J.H.
Title Long-term consequences of intraoperative spillage of bile and gallstones during laparoscopic cholecystectomy
Journal name Journal of Gastrointestinal Surgery   Check publisher's open access policy
ISSN 1091-255X
1873-4626
Publication date 1997-01
Sub-type Article (original research)
DOI 10.1007/s11605-006-0014-x
Open Access Status Not Open Access
Volume 1
Issue 1
Start page 85
End page 91
Total pages 7
Place of publication New York, United States
Publisher Springer New York LLC
Formatted abstract
Laparoscopic cholecystectomy is associated with a higher incidence of iatrogenic perforation of the gallbladder than open cholecystectomy. The long-term consequences of spilled bile and gallstones are unknown. Data were collected prospectively from 1059 consecutive patients undergoing laparoscopic cholecystectomy over a 3-year period. Details of the operative procedures and postoperative course of patients in whom gallbladder perforation occurred were reviewed. Long-term follow-up (range 24 to 59 months) was available for 92% of patients. Intraoperative perforation of the gallbladder occurred in 306 patients (29%); it was more common in men and was associated with increasing age, body weight, and the presence of omental adhesions (each P < 0.001). There was no increased risk in patients with acute cholecystitis (P = 0.13). Postoperatively pyrexia was more common in patients with spillage of gallbladder contents (18% vs. 9%; P < 0.001). Of the patients with long-term follow-up, intra-abdominal abscess developed in 1 (0.6%) of 177 with spillage of only bile, and in 3 (2.9%) of 103 patients with spillage of both bile and gallstones, whereas no intra-abdominal abscesses occurred in the 697 patients in whom the gallbladder was removed intact (P < 0.001). Intraperitoneal spillage of gallbladder contents during laparoscopic cholecystectomy is associated with an increased risk of intra-abdominal abscess. Attempts should be made to irrigate the operative field to evacuate spilled bile and to retrieve all gallstones spilled during the operative procedure.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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