scholarly journals 237 Massive Subcapsular Intra-hepatic Haematoma Post-laparoscopic Cholecystectomy: A Rare Complication of a Common Procedure

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E Saad ◽  
L O'Connell
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Rare Complication ◽  
Postoperative Bleeding ◽  
Bile Leak ◽  
Decisive Role ◽  
Biliary Colic ◽  
Post Discharge ◽  
Common Procedure ◽  
The Right ◽  
Hepatic Haematoma

Abstract Abstract Laparoscopic cholecystectomy (LC) is currently considered the gold standard for the management of symptomatic gallbladder stones disease. Specific complications remain challenging, particularly postoperative bleeding, bile leak, and bile duct injury. We report a rare case of a giant intrahepatic subcapsular haematoma (ISH) complicating LC. Case Presentation A 59-year-old female presented with symptomatic biliary colic. Her past medical history was noted for obesity (BMI > 50). She underwent an elective LC with an uncomplicated intraoperative course; however, post-operatively she developed hypovolaemic shock with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. Emergency CT revealed a massive subcapsular haematoma measuring 21cm×3.1cm× 17cm at the right liver margin without evidence of ongoing bleeding. She was managed conservatively- as per a tertiary hepatobiliary surgery centre’s advice- with meticulous clinical observations, serial monitoring of haemoglobin, and repeat CT to assess for interval progressions. She progressed well with conservative management and did not require surgical or radiological intervention. A follow-up liver US performed eight weeks post-discharge confirmed a complete resolution. Conclusions Giant ISH is an exceedingly rare but life-threatening complication following LC which merits special attention. Our case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH in those who experience a refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post LC-ISH

scholarly journals 143 Massive Intra-Hepatic Subcapsular Liver Haematoma Post-Laparoscopic Cholecystectomy- A Rare Complication of a Common Procedure'

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E Saad ◽  
L O'Connell ◽  
I Khan ◽  
K Barry
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Rare Complication ◽  
Postoperative Bleeding ◽  
Bile Leak ◽  
Decisive Role ◽  
Biliary Colic ◽  
Post Discharge ◽  
Common Procedure ◽  
Life Threatening ◽  
The Right

Abstract Laparoscopic Cholecystectomy (LC) is currently considered the gold standard for the management of symptomatic gallbladder stones disease. Specific complications remain challenging, particularly postoperative bleeding, bile leak, and bile duct injury. We report a rare case of a giant intrahepatic subcapsular haematoma (ISH) complicating LC. Case Presentation A 59-year-old female presented with symptomatic biliary colic. Her past medical history was noted for obesity (BMI>50). She underwent an elective LC with an uncomplicated intraoperative course; however, post-operatively she developed hypovolaemic shock with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. Emergency CT revealed a massive subcapsular haematoma measuring 21cm×3.1cm× 17cm at the right liver margin without evidence of ongoing bleeding. She was managed conservatively- as per a tertiary hepatobiliary surgery centre’s advice- with meticulous clinical observations, serial monitoring of haemoglobin, and repeat CT to assess for interval progressions. She progressed well with conservative management and did not require surgical or radiological intervention. A follow-up liver sonography performed eight weeks post-discharge confirmed a complete resolution. Conclusion Giant ISH is an exceedingly rare but life-threatening complication following LC which merits special attention. Our case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH in those who experience refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post-LC ISH.

scholarly journals Giant Intrahepatic Subcapsular Haematoma: A Rare Complication following Laparoscopic Cholecystectomy—A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eltaib Saad ◽  
Lauren O’Connell ◽  
Anne M. Browne ◽  
W. Khan ◽  
R. Waldron ◽  
...  
Keyword(s):  
Rare Complication ◽  
Rare Event ◽  
Decisive Role ◽  
Postoperative Monitoring ◽  
Refractory Hypotension ◽  
Life Threatening ◽  
The Right ◽  
Tomography Scan

We report on a 59-year-old female with symptomatic cholelithiasis on a background of morbid obesity who underwent an elective LC with an uncomplicated intraoperative course; however, she experienced a refractory hypotension within one hour postoperatively with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. A triphasic computed tomography scan revealed a large intrahepatic subcapsular haematoma (ISH) measuring 21   cm × 3.1   cm × 17   cm surrounding the lateral surface of the right hepatic lobe without active bleeding. She was managed conservatively with serial monitoring of haemoglobin and haematoma size. A follow-up ultrasound scan after eight weeks confirmed complete resolution of the haematoma. Giant ISH is a fairly rare, but life-threatening complication following LC which merits special attention. This case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH, although being rare event, in those who experience a refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post LC-ISH.

scholarly journals Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

2018 ◽  
Vol 12 (3) ◽  
pp. 686-691 ◽  
Author(s):  
Anne M. Schreuder ◽  
Thomas M. van Gulik ◽  
Erik A.J. Rauws
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Stone Formation ◽  
Rare Complication ◽  
Arterial Embolization ◽  
Stone Extraction ◽  
Pseudo Aneurysm ◽  
The Common ◽  
The Right ◽  
And Function

Clips inserted during laparoscopic cholecystectomy (LC) may migrate into the biliary system and function as a nidus for the formation of gallstones. Here, we present a series of 4 patients who presented with this rare complication 5–17 years after LC. All 4 patients presented with symptomatic choledocholithiasis with biochemical and radiological signs of biliary obstruction. Three patients also had fever and infectious parameters, compatible with concurrent cholangitis. All patients successfully underwent endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy and stone extraction. Patients with cholangitis also had antibiotic treatment. In 3 patients, obstruction of the common bile duct was caused by a single, relatively large stone that had formed around a clip (supposedly the cystic duct clip). In 1 patient, multiple stones had formed around an intrabiliary migrated cluster of coils that had been used for arterial embolization of a pseudo-aneurysm of the right hepatic artery. In conclusion, surgical clips and coils can migrate into the biliary tract and serve as a nidus for the formation of bile duct stones. Although rare, this complication should caution surgeons not to place clips “at random” during cholecystectomy. Patients with this rare complication are best managed by ERCP in combination with sphincterotomy and stone extraction.

scholarly journals A Case of Persistent Hiccup after Laparoscopic Cholecystectomy

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Elisa Grifoni ◽  
Costanza Marchiani ◽  
Alessia Fabbri ◽  
Gabriele Ciuti ◽  
Andrea Pavellini ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Histological Analysis ◽  
Rare Complication ◽  
Malignant Lesion ◽  
Tracer Uptake ◽  
Surgical Specimen ◽  
Positron Emission ◽  
Transthoracic Biopsy ◽  
History Of ◽  
The Right

A 79-year-old man, with history of recent laparoscopic cholecystectomy, came to our attention for persistent hiccup, dysphonia, and dysphagia. Noninvasive imaging studies showed a nodular lesion in the right hepatic lobe with transdiaphragmatic infiltration and increased tracer uptake on positron emission tomography. Suspecting a malignant lesion and given the difficulty of performing a percutaneous transthoracic biopsy, the patient underwent surgery. Histological analysis of surgical specimen showed biliary gallstones surrounded by exudative inflammation, resulting from gallbladder rupture and gallstones spillage as a complication of the previous surgical intervention. This case highlights the importance of considering such rare complication after laparoscopic cholecystectomy.

scholarly journals Study of open cholecystectomy for gallbladder disorders

2021 ◽  
Vol 8 (3) ◽  
pp. 826
Author(s):  
Sunil Kumar ◽  
T. Rudra Prasad Reddy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Clinical Judgment ◽  
Open Cholecystectomy ◽  
Standard Procedure ◽  
Demographic Data ◽  
Bile Leak ◽  
Laparoscopic Approach ◽  
Biliary Colic ◽  
Medical College ◽  
Conversion To Open Cholecystectomy

Background: Cholecystectomy is one of the most common surgeries done worldwide. Most common indication is biliary colic due to cholelithiasis. Presently most cholecystectomies are done by laparoscopic approach, however conversion to open cholecystectomy is needed in few circumstances and there are some absolute indications for open cholecystectomy where laparoscopic procedure can’t be done.Methods: This is a prospective observational study of 50 open cholecystectomies operated during March 2017 to Feb 2019 in our medical college. Various data including demographic data of patients, different indications, post-operative complications were documented and analyzed.Results: Mean age of the patients was 40.58 (16-65) years. Female patients were more in number 32 (64%) when compared with males. Maximum patients were in the age group 31-40 years accounting to 17 (34%) of study population. Pain abdomen 24 (48%) was the chief presenting complaint. Cholelithiasis 38 (76%) was the major indication for surgery. Complications like bile leak, bleeding, subphrenic abscess and infection occurred in 04 (08%) patients. Total four cases of laparoscopic cholecystectomy were converted to open cholecystectomy. Mean hospital stay was 7.48 (5-14) days.Conclusions: Even though laparoscopic cholecystectomy is the gold standard in the present era, it is important that the surgeon is also competent in doing open cholecystectomy. Certain conditions require planned open cholecystectomy as the standard procedure. In difficult laparoscopic cases, the surgeon must take timely decision to convert to the open technique. Surgeons experience and proper clinical judgment skills are important in difficult cases.

scholarly journals Chronic right lumbar suppuration following stone forgotten during laparoscopic cholecystectomy

2017 ◽  
Vol 4 (4) ◽  
pp. 1494
Author(s):  
Mohamed Amine Elghali ◽  
Ikram Massoudi ◽  
Rafik Ghrissi ◽  
Tarek Dhibet ◽  
Fehmi Hamila
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Rare Complication ◽  
Surgical Removal ◽  
Difficult Diagnosis ◽  
Common Event ◽  
The Right

The breaking of the gallbladder during laparoscopic cholecystectomy east of a common event, and usually harmless, even if stone are missed. Exceptionally these calculations are causing persistent suppuration and may pose therapeutic problems. We report the case of a woman who presented a chronic suppurative the right lumbar pit months after laparoscopic cholecystectomy. This illustrates the observations difficult diagnosis of this rare complication and providing imaging. as in our case, surgical removal of the calculi is the only way to ensure healing.

scholarly journals CBD Stone Formation Over Migrated Surgical Clip: A Rare Complication Developed Fourteen Years after Laparoscopic Cholecystectomy

2019 ◽  
Vol 10 (03) ◽  
pp. 188-190
Author(s):  
Parth Shah ◽  
Pravin Rathi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Foreign Bodies ◽  
Stone Formation ◽  
Rare Complication ◽  
Biliary Colic ◽  
Surgical Clips ◽  
Surgical Clip ◽  
Symptomatic Gallstones ◽  
History Of ◽  
Cbd Stone

AbstractLaparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Migration of surgical clips into common bile duct (CBD) is a rare complication after LC. Migrated surgical clips may lead to further complications like cholangitis, choledocholithiasis. We report a rare case of CBD stone formed over migrated surgical clips, 14 years after LC. A 41-year-old male with history of LC 14 years back, presented with repeated episodes of biliary colic. Computed tomography (CT) scan abdomen showed CBD stones with metallic foreign bodies and prominent CBD. Patient was managed successfully with endoscopic retrograde cholangiopancreatography. Patient became asymptomatic thereafter. This case is a rare complication developed after a very commonly performed surgery.

Arteriovenous Fistula—A Rare Complication of IVC Filter Retrieval

2019 ◽  
Vol 53 (6) ◽  
pp. 501-506 ◽  
Author(s):  
Charisma DeSai ◽  
Daniel Lamus ◽  
Girish Kumar
Keyword(s):  
Arteriovenous Fistula ◽  
Rare Complication ◽  
Vena Cava ◽  
Ivc Filter ◽  
Common Procedure ◽  
Filter Retrieval ◽  
Ivc Filters ◽  
Important Quality ◽  
The Right ◽  
Rate Of Success

Inferior vena cava (IVC) filters are important devices for patients who are at high risk for developing thrombi and pulmonary embolism but have conditions that preclude the use of pharmacologic anticoagulants. IVC filter retrieval has become an important quality initiative backed by Food and Drug Administration guidelines for prompt removal after the filter is no longer indicated. Filter retrieval is a common procedure that usually has very few complications. However, when the filter is tilted or embedded in the caval wall, advanced techniques of retrieval may be necessary. These techniques have a higher rate of success but also a higher risk of complications such as injury to the IVC. Here, we describe a case of IVC filter retrieval resulting in formation of an arteriovenous fistula between the right renal artery and IVC and subsequent successful repair of this fistula using a vascular plug.

scholarly journals Retrograde Pyelogram during intended Cystogram: A Rare complication of a common procedure

2018 ◽  
Vol 8 ◽  
pp. 55 ◽  
Author(s):  
Shanmugasundaram Rajaian ◽  
Pragatheeswarane Murugavaithianathan ◽  
Karrthik Krishnamurthy ◽  
Lakshman Murugesan
Keyword(s):  
Urinary Catheter ◽  
Rare Complication ◽  
Laparoscopic Hysterectomy ◽  
Early Postoperative Period ◽  
Contrast Extravasation ◽  
Common Procedure ◽  
Retrograde Pyelogram ◽  
Foley’S Catheter ◽  
Threatening Situation ◽  
The Right

Inadvertent placement of the urinary catheter into the ureter can cause several complications. We describe a rare complication during cystogram due to unrecognized inadvertently placed urinary catheter in ureter, resulting in a life-threatening situation. A 47-year-old multiparous female underwent total laparoscopic hysterectomy for adenomyosis. During early postoperative period, she developed vesicovaginal fistula and transvaginal repair of fistula was done. During filling cystography done at 2 weeks, she developed right loin pain and urosepsis. Contrast extravasation was seen in the right renal subcapsular space with Foley's catheter inside the right ureter. Subsequently, she recovered well.

scholarly journals SPILLED BILE AND GALLSTONES

2016 ◽  
Vol 23 (08) ◽  
pp. 964-969
Author(s):  
Abdul Mannan Khan Rao ◽  
Dr. Abdul Ghafoor Dalwani ◽  
Champa Sushel ◽  
Ubedullah Shaikh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Leak ◽  
University Hospital ◽  
Biliary Colic ◽  
Long Period

Objectives: Intra-peritoneal bile leak and gallstones spillage is a commonevent, during laparoscopic cholecystectomy. Some time it is not possible to retrieve all spiltgallstones, these unretrieved intra-peritoneal gallstones, initially considered harmless, with timea number of complications have been reported. Our aim was to study, factors predisposing togallbladder perforation during laparoscopic cholecystectomy, and the incidence and adverseconsequences of intra-peritoneal spilt gallstone. Period: November 2008 to December 2011.Setting: Liaquat University Hospital were studied. Method: Patients who underwent successfullaparoscopic cholecystectomy for biliary colic and cholelitiasis. Patients who had intraperitonealbile and gallstones spillage during laparoscopic cholecystectomy were follow upfor long period, and all patients studied for risk of perforation and complications. Results:1038 patient underwent successful laparoscopic cholecystectomy, among them in 812(78.23%)patient intact gallbladder were removed, and in 226 (21.77%) patient gallbladder perforationoccurred. Patients had gallbladder perforations in 129(12.43) patients only bile leak was noted,and in 97(9.34%) patients bile and gallstones spillage occurred. Conclusion: We concludedthe outcome and incidence of serious complications after intra-operative spillage of gallstonesand bile, during laparoscopic cholecystectomy, is low and avoidable.

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