The Effect of Gallbladder Wall Thickness on Intraoperative Adverse Events during Laparoscopic Cholecystectomy

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The Lasallian Journal of Medicine and Health Sciences


Objective: This study aims to determine whether the different degrees of gallbladder wall thickness determined by ultrasound affect the rate of complications during laparoscopic cholecystectomy.

Methods: The medical records of the patients who underwent laparoscopic cholecystectomy from January 2012 until September 2013 were reviewed. The data gathered included the patient demographics, gallbladder wall thickness based on ultrasound, intraoperative events an d post operative complications, conversion to open cholecystectomy, gallbladder wall thickness (in centimeters) on histopathology, and hospital stay. The patients ere classified based on gallbladder wall thickness and a multinomial logistic regression analysis for the intraoperative events and post-operative complications with the degree of gallbladder wall thickness was subsequently conducted.

Result: There were 359 patients who underwent laparoscopic cholecystectomy from January 2012 to September 2013 whose age ranged from 12-92 (median 52 years). There were 226 females (63%) and 133 males (37%). The average operating time was 82.87 +- 33.87 minutes with a range of 25-255 minutes. There was only one reported case of conversion to open cholecystectomy due to difficulty in defining the anatomy. Intraoperative events included intentional gallbladder perforation (0.3%) and non intentional gallbladder perforation (4.5%), bleeding (5.8%) cystic duct injury (0.3%) and bowel injury (0.3%). Post operative complication included 5 (1.4%) case of surgical site infection and one case of retained stone (0.3%). Majority of the patients had gallbladder wall thickness ranging from 1-2 mm.

Conclusion: There is no enough evidence to show that the degree of gallbladder wall thickness will affect the occurrence of intraoperative and post intraoperative complications during laparoscopic cholecystectomy.

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