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Imaging of the complications of laparoscopic cholecystectomy

  • Hepatobiliary-Pancreas
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Abstract

Laparoscopic cholecystectomy has, in recent years, emerged as the gold standard therapeutic option for the management of uncomplicated symptomatic cholelithiasis. Each year, up to 700,000 of these procedures are performed in the United States alone. While the relative rate of post-procedural complications is low, the popularity of this method of gallbladder removal is such that this entity is not uncommonly clinically encountered, and therefore must be borne in mind by the investigating physician. By way of pictorial review, we explore the radiological appearances of a variety of potential complications of laparoscopic cholecystectomy. The radiological appearances of each shall be illustrated in turn using several imaging modalities, including ultrasound, computed tomography, MR cholangiography and radio-isotope scintigraphy. From calculus retention to portal vein laceration, bile duct injury to infected dropped calculi, we illustrate numerous potential complications of this procedure, as well as indicating the most suitable imaging modalities available for the detection of these adverse outcomes. As one of the most commonly performed intra-abdominal surgeries, laparoscopic cholecystectomy and the complications thereof are not uncommonly encountered. Awareness of the possible presence of these numerous complications, including their radiological appearances, makes early detection more likely, with resultant improved patient outcome.

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References

  1. Fathy O, Zeid MA, Abdallah T, Fouad A, Eleinien AA, el-Hak NG et al (2003) Laparoscopic cholecystectomy: a report on 2000 cases. Hepatogastroenterology 50(52):967–971

    CAS  PubMed  Google Scholar 

  2. Puljiz Z, Kuna T, Franjic BD, Hochstädter H, Matejcic A, Beslin MB (2003) Bile duct injuries during open and laparoscopic cholecystectomy at Sestre Milosrdnice University Hospital from 1995 till 2001. Acta Clin Croat 42:217–223

    Google Scholar 

  3. Traverso LW, Hauptmann EM, Lynge DC (1994) Routine intraoperative cholangiography and its contribution to the selective cholangiographer. Am J Surg 167:464–468

    Article  CAS  PubMed  Google Scholar 

  4. Usal H, Sayad P, Hayek N, Hallak A, Huie F, Ferzli G (1998) Major vascular injuries during laparoscopic cholecystectomy. An institutional review of experience with 2589 procedures and literature review. Surg Endosc 12(7):960–962

    Article  CAS  PubMed  Google Scholar 

  5. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC (1993) Complications of laparoscopic cholecystectomy: a national survey of 4292 hospitals and an analysis of 77604 cases. Am J Surg 165(1):9–14

    CAS  PubMed  Google Scholar 

  6. Modini C, Mingoli A, Castaldo P, Sgarzini G, Marzano M, Nardacchione F (1996) Aortic laceration during laparoscopic cholecystectomy that required delayed emergency laparotomy. Eur J Surg 162(9):739–741

    CAS  PubMed  Google Scholar 

  7. Flum DR, Cheadle A, Prela C, Dellinger EP, Chan L (2003) Bile duct injury during cholecystectomy and survival in medicare beneficiaries. J Am Med Assoc 290(16):2168–2173

    Article  CAS  Google Scholar 

  8. Asbun HJ, Rossi RL, Lowell JA, Munson JL (1993) Bile duct injury during laparoscopic cholecystectomy: mechanism of injury, prevention and management. World J Surg 17(4):547–552

    CAS  PubMed  Google Scholar 

  9. Russell E, Yrizzary JM, Montalvo BM, Guerra JJ, Al-Refai F (1990) Left hepatic duct anatomy: implications. Radiology 174:353–356

    CAS  PubMed  Google Scholar 

  10. Taourel P, Bret PM, Reinhold C, Barkun AN, Atri M (1996) Anatomic cariants of the biliary tree: diagnosis with MR cholangiopancreatography. Radiology 199:521–527

    CAS  PubMed  Google Scholar 

  11. Lee VS, Rofsky GR, Teperman LW, Krinsky GA, Berman P et al (2001) Volumetric mangafodipir trisodium-enhanced cholangiography to define intrahepatic biliary anatomy. Am J Roentgenol 176:906–908

    CAS  Google Scholar 

  12. Davids PH, Ringers J, Rauws EA, de Wit LT, Huibregtse K, van der Heyde MN, Tytgat GN (1993) Bile duct injury after laparoscopic cholecystectomy: the value of endoscopic retrograde cholangiopancreatography. Gut 34(9):1250–1254

    CAS  PubMed  Google Scholar 

  13. Morrin MM, Kruskal JB, Hochman MG, Saldinger PF, Kane RA (2000) Radiologic features of complications arising from dropped gallstones in laparoscopic cholecystectomy patients. Am J Roentgenol 174(5):1441–1445

    CAS  Google Scholar 

  14. Rice DC, Memon MA, Jamison RL, Agnessi T, Ilstrup D, Bannon MB et al (1997) Long-term consequences of intraoperative spillage of bile and gallstones during laparoscopic cholecystectomy. J Gastrointest Surg 1(1):85–91

    Article  PubMed  Google Scholar 

  15. Hussain S (2001) Sepsis from dropped clips at laparoscopic cholecystectomy. Eur J Radiol 40(3):244–247

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank Dr John Curtis, RLUH, Aintree, United Kingdom, for kindly providing Fig. 12.

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Correspondence to Derek Lohan.

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Lohan, D., Walsh, S., McLoughlin, R. et al. Imaging of the complications of laparoscopic cholecystectomy. Eur Radiol 15, 904–912 (2005). https://doi.org/10.1007/s00330-004-2519-6

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  • DOI: https://doi.org/10.1007/s00330-004-2519-6

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