Postoperative incidence of iatrogenic gallbladder perforation during laparoscopic cholecystectomy in Sulaimaniyah Teaching Hospital

Abstract

Background and objective: Iatrogenic perforation of the gallbladder has been reported in 28% of those patients who undergo laparoscopic cholecystectomy. It has been pointed out that gallbladder perforation can result in formation of gallstones and spillage of bile. The present study was carried out in order to investigate the postoperative incidence of iatrogenic gallbladder perforation during laparoscopic cholecystectomy in Sulaimani Teaching Hospital. Patients   and   methods:   The   present   investigation   was   a   single   center, retrospective observational study that was carried out in Sulaimani Teaching Hospital  in  2018-2019.  The  study  sample  included  99  patients  who  had undergone elective cholecystectomy. Required data on the possible risk factors and early outcomes and the patients’ demographics including age, BMI, and gender were collected. The collected data were analyzed through the Statistical Package for the Social Sciences (version 22.0.( 
Results: The results revealed that 80% of the patients were females. Also, 42.4% had no chronic diseases, while diabetes mellitus (DM), DM along with hypertension  (HT),  and  HT  were  found  to  be  the  most  prevalent  chronic diseases  among  them  with  18.2%,  16.2%,  and  10.1%  of  prevalence, respectively. Only 17.2% of the patients had abdominal operation before, and acute cholecystitis and chronic cholecystitis were seen respectivelyin 13% and 17% of them. The most common causes of gallbladder perforation (GP) were found to be electrocautery (16.2%) and grasper (7.1%). Moreover, 33.3% of the patients were overweight (BMI between 25 and 29.9), 45.5% were obese (BMI between 30 and 34.9), and 20.2% had BMI of over 35. Most of the patients aged 30 to 49 (62.6%). A majority of the patients (94.9%) were found to have gallstones. 
Conclusion:  Iatrogenic  gallbladder  perforation  is  prevalent  among  patients who  undergo  laparoscopic  cholecystectomy.  However,  laparoscopic cholecystectomy  is  still  a  better  choice  and  associated  with  fewer complications compared to open cholecystectomy. Required measures need to be  adopted  for  patients  with  perforated  gallbladder  in  order  to  minimize spillage and remove as much spilled gallbladder content as possible.