Experience in perioperative management in difficult laparoscopic cholecystectomy

Objective To investigate perioperative management and the prevention of complications in difficult laparoscopic cholecystectomy. Methods A retrospective analysis was performed on the clinical data of 82 patients, who underwent difficult laparoscopic cholecystectomy due to acute cholecystitis, Mirizzi syndrome, a history of abdominal surgery with severe abdominal adhesion, atrophic cholecystitis, liver cirrhosis with gallstones, and other diseases in our hospital since 1999, to summarize the experiences and lessons. Results Among all patients, 6 ( 7. 31%) were converted to open laparotomy, and other patients were successfully treated by laparoscopic cholecystectomy.Postoperative biliary injury and biliary fistula occurred in 2 cases, and they were cured after reoperation. Postoperative bleeding occurred in4 cases, and they were cured with conservative treatment. Different degrees of biliary leak of unknown causes occurred in 10 cases, and they were cured after drainage. Conclusion For difficult laparoscopic cholecystectomy, surgical operation is characterized by high difficulty and high risk, but it can still be completed with proper perioperative management.