Case Series on Difficult Laparoscopic Cholecystectomy

Abstract

Since its introduction, the laparoscopic cholecystectomy procedure has evolved progressively due to
improvements in optics and instrumentation. Miniaturization of instruments and thus trocar sites has continued.
This prospective study was conducted at the department of General Surgery, Civil hospital, Ahmedabad, all 25
cases of elective cholecystectomies done that fell in inclusive criteria. In my study, out of 25 cases, Calot's triangle
dissection was difficult due to adhesions, fibrosis & inflammation in 04 patients, 02 out of these got converted to
open Cholecystectomy. Empyema of Gall bladder was present in 03 patients, 01 of these were converted to open
surgery. Bleeding from Gall bladder fossa was present in 01 patient controlled later on, difficulty in applying Clip to
cystic duct was present in 01 patient due to short cystic duct, gall bladder extraction was difficult in 01 patients
because of multiple stones in gall bladder, one patient had port-site bleeding. In present study 2 patients (08%)
converted to conventional open cholecystectomy with 02 patients having bile leak as a complication.