EFFICACY OF LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT ON TABLE CHOLANGIOGRAPHY AND INCIDENCE OF INJURY TO BILE DUCT

Aim: To determine the safety of laparoscopic cholecystectomy without on table cholangiography.

Study design: A quasi-experimental study

Place and duration: Conducted in Surgical department of New City Teaching Hospital, Mirpur for one-year duration from June 2019 to June 2020.

Methodology: Patients with acute or chronic cholecystitis due to gallstones were included in the study, while patients with obstructive jaundice and gallbladder mass were excluded. All patients were operated on by laparoscopic cholecystectomy without table cholangiography. In the course of the procedure, damage to the bile ducts was noted and evidence of damage to the bile ducts was collected after surgery during hospitalization and follow-up visits. Data on complications related to damage to the bile ducts were recorded and analyzed.

Results: In this series, a total of 7 (0.92%) injuries of the biliary tract were reported. There were two (0.26%) cases of partial damage to the common hepatic duct, 1 of which was a case of Mirizzi syndrome. In the second case, the common hepatic duct was partially damaged during an attempt to cauterize the severed branch of the cystic artery. Two (0.26%) patients developed partial damage to the common bile duct as a result of dislocation of the common bile duct. Complete transaction of the common bile duct occurred in two (0.26%) cases. One patient (0.13%) had a postoperative leak due to rupture of the bile-hepatic duct.

Conclusion: This study shows that the absence of an OTC facility does not lead to a disturbingly increased rate of biliary tract injuries during laparoscopic cholecystectomy.

Keywords: laparoscopic cholecystectomy (LC), common bile duct (CBD), table-top cholangiogram (OTC), ultrasound (USG)