D.M. KRASILNIKOV^1,2, D.M. MIRGASIMOVA¹, A.V. ABDULYANOV¹, R.R. SHIGABUTDINOV², A.V. ZAKHAROVA¹

¹Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

²Republican Clinical Hospital of the MH of the RT, 138 Orenburgskiy Trakt, Kazan, Russian Federation, 420064 

Krasilnikov D.M. ― D. Med. Sc., Professor, Head of the Department of Surgical Diseases №1, Head of Surgical Clinic, tеl. (843) 231-21-35, e-mail: dmkras131@gmail.com

Mirgasimova D.M. ― Cand. Med. Sc., Associate Professor of the Department of Surgical Diseases №1, tel. +7-904-667-45-51, e-mail: d.mirgasimova@yandex.ru

Abdulyanov A.V. ― Cand. Med. Sc., Associate Professor of the Department of Surgical Diseases №1, tel. +7-903-387-21-78, e-mail: aabdulianov@mail.ru

Shigabutdinov R.R. ― Head of the Department of Endoscopy, tel. +7-917-267-31-56, e-mail: shigabutdinov1969@mail.ru

Zakharova A.V. ― Cand. Med. Sc., Assistant of the Department of Surgical Diseases №1, tel. +7-927-408-22-07, e-mail: zahanna.83@rambler.ru 

The results of 3715 cases of laparoscopic cholecystectomy are analyzed in this article. Complications nave arisen in 22 cases (0.59%), including iatrogenic damages to the bile ducts in 4 patients (0.12%), intraabdominal haemorrhages ― 4 (0.12%), bile leakage ― 7 (0.18%), subhepatic abscesses ― 6 (0.16%), subcutaneous eventration of jejunum in periomphalic wound ― 1 (0.027%). To diagnose complications were applied ultrasonography (US), hepatobiliary scintigraphy, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP). In most cases, the elimination of complications was performed by minimally invasive interventions: endoscopic papillosphincterotomy (EPST), puncture drainage under ultrasound guidance, relaparoscopy for hemostasis and sanitation of the abdominal cavity. In case of any damage to bile ducts, there was performed reconstructive surgery on different terms. Postoperative mortality was 0.27% (10 patients), the cause of death was extraabdominal pathology.

Key words: laparoscopic cholecystectomy, complications, iatrogenic trauma, diagnosis, treatment.

REFERENCES

1. Rukovodstvo po khirurgii zhelchnykh putey, pod red. E.I. Gal’perina, P.S. Vetsheva [Guidelines for surgery of the biliary tract. Ed. by E.I. Halperin, P.S. Vetshev]. Moscow, 2009. 568 p.
2. Pospelov D. Laparoscopic cholecystectomy. Tactics of treatment of the most dangerous oslozheny. Ukr. med. chasopsis, 2012, no. 10, pp. 1-3 (in Russ.).
3. Krasil’nikov D.M. Rannie posleoperatsionnye oslozhneniya u bol’nykh kal’kuleznym kholetsistitom i kholedokholitiazom [Early postoperative complications in patients with calculous cholecystitis and choledocholithiasis]. Kazan: Meditsina, 2008. 176 p.
4. Fedorov I.V., Sigal E.I., Burmistrov M.V. Oslozhneniya endoskopicheskoy khirurgii, ginekologii, urologii [Complications of endoscopic surgery, gynecology, urology]. Moscow: Triada-Kh, 2012. 288 p.
5. Gal’perin E.I., A.Yu. Chevokin «Fresh» damage to the bile ducts. Khirurgiya. Zhurn. im. N.I. Pirogova, 2010, no. 10, pp. 4-10 (in Russ.).
6. Kurbanov D.M., Rasulov N.I., Ashurov A.S. Complications of laparoscopic cholecystectomy surgery. Novosti khirurgii, 2014, vol. 22 (3) 3, pp. 366-373 (in Russ.).
7. Sheth K.R., Pappas T.N. Operative management of cholecystitis and cholelithiasis. Shackelford’s surgery of the alimentary tract. 6th edition. Philadelphia: WB Saunders, 2007. Pp. 1471-1481.
8. Lien H.H., Huang S.C., Liu J.S. System approach to prevent common bile duct injury andenhance performance of laparoscopic cholecystectomy. Surg. Laparosc. Endosc. Percutan Tech, 2007, vol. 17 (3), pp. 164-170.
9. Karvonen J. Quality of life after iatrogenic bile duct injury — a case control stady. Minim Invasive Ther Allied Technol, 2013 Jun, vol. 22, no. 3, rr. 177-180.