Nurkan Törer, Tarık Zafer Nursal, Kenan Çalışkan, Ali Ezer, Tamer Çolakoğlu, Hamdi Karakayalı, Mehmet Haberal

Başkent Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, Ankara


Background: We aim to share our experience on major complications of cholecystectomy.

Methods: Records of patients operated for major cholecystectomy complications between May 1999 - November 2007 were analyzed. Type of cholecystectomy, clinical complaint, type of injury, period from first operation to referral and referral to corrective surgery, postoperative complications and long-term outcome were recorded.

Results: Median age of 22 patients was 50 (27 – 73), female/male ratio was 1.2. Type of cholecystectomy was laparoscopic cholecystectomy (LC) (n=9), open cholecystectomy (OC) (n=8), bilioenterostomy (due to post-cholecystectomy benign biliary stricture) (n=2), conversion to open cholecystectomy (COC) (n=3). Detected type of injury was; Type-B (n=7), Type-C (n=11), Type-D (n=3) and unclassified (n=1) according to Amsterdam classification. All of the Type-B injuries were observed in four LC and three COC patients and none of the OC patients. However, in the OC group, most frequent type of injury was Type-C (n=6/8) (p=0.029).

One patient died, 7 patients had complication, and two patients had recurrent biliary problems. Complication rate was more frequent for; Type-D injury (2/3 p=0.167), patients with early (<10 days) presentation (5/9 - 2/13) (p=0.046) and patients with early (<10 days) surgical intervention (6/13 - 1/9) (p=0.069). Experiencing recurrent problem rate was more frequent for the patients with early surgical intervention (2/12 – 0/9) (p=0.178).

Conclusion: Most frequent complication of OC was biliary strictures and that of LC was bile leakage.

Keywords: Cholecystectomy, biliary injury, surgical repair