Abstract
The causes and preventive management were evaluated for intraoperative troubles in 83 cases of laparoscopic cholecystectomy performed at the department since December 1990. In respect of troubles based on insufflation there were 1 omental and 2 subcutaneous emphysemas, and all of which were cured conservatively. Troubles based on operative technique included arterial bleeding in 3 cases, perforation of the gallbladder in 10 cases and injury of cystic duct in one case. One of the arterial bleeding experienced in early days was converted to open surgery for hemostasis, but the others were restored by only clipping. Half of perforations of the gallbladder could not be restored untill the end of cholecystectomy, and therefore the gallbladder was withdrawn from body cavity by putting it into a condom. The injury of cystic duct was due to the side burn of electrocautery, for which a ligation of the cystic duct was performed on the 1st postoperative day. Three cases with bleeding from the liver bed, which could not be well controlled, underwent a removal of insufflation and gauzy oppression for hemostasis. In this paper our cases as well as a review of the literature are presented.
