COMPLICATIONS OF OPEN CHOLECYSTECTOMY IN SYMPTOMATIC CHOLELITHIASIS PATIENTS

Abstract

Background: Awareness of morbidity as a major surgical constraint has led the surgical fraternity to proceed from conventional to the more recent laparoscopic cholecystectomies. But developing countries still lack the availability of infrastructure and expertise for widespread use of minimal access and open cholecystectomy still continues to be the widely used method of cholecystectomy. The objective of this study was to determine the peroperative and early postoperative complications of open cholecystectomy.
Material & methods: This descriptive study was carried out at Department of Surgery, Peshawar Institute of Medical Sciences, Hayatabad, Peshawar. A total of 100 cases with symptomatic cholelithiasis were operated by open cholecystectomy from January 2011 to December 2012. Peroperative and early postoperative complications were recorded.
Results: Among complications of access; difficulty in identification of anatomy was noted in 10% cases. Among procedure complications; vascular injury was recorded in 6%; bile duct injury in 2%, dropped stones in peritoneal cavity in 2%, and perforation of gallbladder in 2%. Postoperative complications on first day after operation i.e. bile leak in drain was noted in 6% cases, and fever in 4% cases. Postoperative complications on first follow-up visit i.e. wound infection was seen in 6% cases, sub-hepatic collection in 4%, and chest infection in 4% cases. Mean hospital stay was 68 hours.
Conclusions: Open cholecystectomy is associated with few per and post-operative complications and we still recommend it in the management of cholelithiasis where facilities for advanced surgery are not available.