COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY AND THEIR INTERVENTIONAL RADIOLOGIC MANAGEMENT

Cholelithiasis and cholecystitis are encountered throughout the world and are responsible for the majority of cholecystectomies performed. Treatment has traditionally consisted of open cholecystectomy, but laparoscopic cholecystectomy is currently a popular alternative. Laparoscopic cholecystectomy offers several benefits over the open procedure, but it also has its own set of complications. Complications include those of laparoscopy (abdominal wall bleeding, omental bleeding, abdominal vessel injury, retroperitoneal vessel injury, gastrointestinal perforation, bladder perforation, solid visceral injury, and infection) and those of cholecystectomy (gallbladder fossa bleeding, bile duct injury, bile leakage, and infection). The literature suggests that the total complication rate for the laparoscopic procedure compares favorably with that of the open procedure, but this may apply only to surgeons who have accomplished numerous laparoscopic procedures and not to those who have just completed a training course and are performing their first few procedures. With the growing success of the laparoscopic procedure, it is essential that the radiologist be knowledgeable about the radiographic manifestations and interventional radiologic management of potential complications, since the radiologist can significantly affect patient care.