Just a decade ago, most gallbladder removal surgeries required five- to eight-inch abdominal incisions and a six-week recovery period. Today, around 80 percent of gallbladder surgeries, known as cholecystectomies, are done laparoscopically, through several very small incisions, the Comprehensive Center for Laparoscopic Surgery states. While laparoscopic cholecystectomy, sometimes abbreviated to lap chole, is safer than traditional abdominal gallbladder removal, serious complications can still occur after either type of surgery.
Bile Duct Complications
Lap chole causes less pain and has a shorter recovery period than traditional abdominal surgery but also results in more frequent bile duct injuries, the Comprehensive Center for Laparoscopic Surgery states. Bile duct injury occurs in one in 1,000 patients undergoing open cholecystectomy and in one to five patients undergoing lap chole, according to the American College of Surgeons. Jaundice and fever are signs of possible bile duct injury. If the bile duct is perforated and bile spills into the abdominal cavity, bile peritonitis, infection of the abdominal cavity can occur. Bile duct injury may require a second surgery to repair the damage.
Trocar Damage
Lap chole surgery requires abdominal insertion of trocars, metal devices that provide access ports into the abdominal cavity. The initial trocar is placed blindly, according to the Food and Drug Administration (FDA), which also states that trocar injuries occur in approximately 3 percent of lap chole surgeries. Potential injuries from improper insertion include damage to the small bowel or liver; the FDA reports the incidence of bowel complications as 1 percent or less. Bleeding can occur if blood vessels are nicked. Obesity and previous abdominal surgery increase the risk of trocar-related complications. Additional surgery may be required to repair damage done during cholecystectomy.
Pregnancy Complications
Either type of cholecystectomy poses special risks for pregnant women. The American College of Surgeons reports that fetal loss occurs in 40 out of 1,000 uncomplicated cases and as many as 600 of 1,000 of cases complicated by pancreatitis, or inflammation of the pancreas.
Other Complications
Other complications from either type of cholecystectomy include pneumonia, blood clots, pancreatitis and kidney or heart problems. Infection occurs in less than one out of 1,000 procedures, according to the American College of Surgeons. In very rare cases, death can occur from gallbladder removal surgery.
References
- American College of Surgeons: Cholecystectomy
- Society of American Gastrointestinal and Endoscopic Surgeons:Laparoscopic Gall Bladder Removal
- Mayo Clinic: Cholecystectomy
- Comprehensive Center for Laparoscopic Surgery: Laparoscopic Gallbaldder Surgery
- Food and Drug Administration: Laparoscopic Trocar Injuries; Janie Fuller, DDS; November 7, 2003
