Complication of lapaoscopic cholecystectomy

- biliary injury

- Bleeding

- Bowel injury

- postcholecystectomy syndrome

 
Biliary injury

Strasberg classification

   
   
Postcholecystectomy syndrome

definition?

- complex of heterogeneous symptoms, including persistent abdominal pain and dyspepsia, that recur and persist after cholecystectomy

  60%: complet relief of abdominal pain at 12 wks after cholecystectomy for umcomplicated symptomatic cholelithiasis
 

Cause

- biliary causes

- extrabiliary causes

 

Biliary causes

- early: biliary injury, retained cystic duct, or common bile duct stones

- late: recurrent common bile duct stones, bile duct strictures, an inflamed cystic duct or gallbladder remnent, papillary stenosis, or biliary dyskinesia (motor forms of sphincter of Oddi dysfunction)

 

Extrabiliary causes

- GI: irritable bowel syndrome, pancreatitis, pancreatic tumors, pamcreatic divisum, hepatits, peptic uker disease, mesenteric ischemia, diverticulitis, or esophageal disease

- Extraintestinal: intercostal neuritis, wound neuroma, coronary artery disease, or psychosomatic disorders