Learning objectives
To be aware of the wide spectrum of complications that occur in patients undergoing cholecystectomy
To describe the imaging findings of these complications
To acknowledge the advantages and limitations of each imaging method
Background
In 1882 Langenbuch revolutionized biliary tract surgery by presenting the first cholecystectomy [1,2].
In the next century,
cholecystectomy became one of the most frequently performed surgical
procedures [3].
During laparoscopic cholecystectomy the gall bladder is removed through very small incisions in the abdominal wall instead of the large incision in the classical cholecystectomy.
Thus,
compared with classical-open cholecystectomy,
it is characterized by shorter hospitalization time,
less post-operative pain,
less chance of surgical wound infection,
better aesthetic effect,
and greater patient satisfaction,
let alone the cost...
Findings and procedure details
1.
Biliary injury
Biliary injury is one of the most frequent complications of laparoscopic procedures (0.3% of open cholecystectomies vs 0.6% of laparoscopic cholecystectomies),
[6].
The most common causes of biliary injuries are:
• Their cross section due to anatomical abnormalities - these anatomical abnormalities may relate to variations of the gallbladder itself,
variants of the cystic duct or in the presence aberrant hepatic ducts
• Incorrect identification of the common bile duct or common hepatic duct as the cystic duct - in cases where...
Conclusion
Radiologist are often called on to recognize or rule out the potential complications after cholecystectomy. Therefore,
it is important to become familiar with the imaging appearance of these post-operative complications,
be aware of the advantages and disadvantages of each imaging modality and learn how to interpret the imaging in the context of the patient’s clinical findings to establish the final diagnosis.
References
1.
Langenbuch CJA.
Ein Fall yon Exstirpation der Gallenblase wegen Chronischer Cholelithiasis.
Berliner Klin Wochenschr 1882; 19:725-727.
2.
Traverso LW.
Carl Langenbuch and the first cholecystectomy.
Am J Surg 1976; 132:81-82.
3.
Leading surgical procedures.
Stat Bull Metropol Life Ins Co 1973; 54: 10.
4.
Yamashita Y,
Takada T,
Kawarada Y,
Nimura Y,
Hirota M,
Miura Fet al.
Surgical treatment of patients with acute cholecystitis:Tokyo Guidelines.J Hepatobiliary Pancreat Surg 2007; 14:91-97.
5.
Sureka B,
Mukund A.
Review of imaging in post-laparoscopy complications.
Indian J Radiol...