Abstract
Background: In 1,577 laparoscopic cholecystectomies, 111 due to acute and 1,466 due to chronic cholecystitis, the incidence of intraoperative gallbladder rupture and its relationship with abdominal wound infections were evaluated.
Methods: A sampling test for binomial proportions and a binomial approximation test for discrete data were employed for statistical analysis. Gallbladder accidental opening took place in 250 (19%) out of the 1,466 chronic and in 44 (40%) out of the 111 acute cholecystitis, disclosing a statistically significant difference (p<0.01). Postoperatively, there were 32 (2%) surgical wound infections, 17 (1.3%) in the absence of gallbladder injury and 15 (5%) when gallbladder injury was observed, likewise showing a statistically significant difference (p<0.05).
Results: It should be pointed out that all 32 wound infections involved the umbilical incision, of which 3 with chronic suppuration required reintervention where remnants of stones were found in the parietal route. The seven with symptomatic abdominal fluid resolved without specific treatment. As regards the seven intraabdominal infections, two remitted with antibiotics and five required percutaneous drainage. There was no significant correlation between the presence of cavity fluid abdominal collections or infections and bile spillage.
Conclusion: Gallbladder injury proved more frequent in laparoscopic cholecystectomies performed due to acute cholecystitis, while bile spillage increased the incidence of umbilical wound infection, particularly in the presence of remnants of stones, but there was no correlative increase in the incidence of intraabdominal collections or infections.
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References
Altemeier WA, Culberston WR (1965) Surgical infection. In: Moyer C et al. (eds) Surgery, principles and practice, 3rd ed. JB Lippincott, Philadelphia
Brachman PS, Dan BB, Haley RW, Hooten TM, Garner NJ, Allen JR (1980) Infecciones quir · rgicas nosocomiales: frecuencia y costo. Clin Quir N AM 1: 31
Cacdac RB, Lakra VP (1993) Abdominal wall sinus tract secondary to gallstones: a complication of laparoscopic cholecystectomy. J Laparoendosc Surg 3: 509–511
Cuschieri A, Dubois F, Mouiel J, Mouret P (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387
Diez JA, Pujato MR, Ferreres AR (1990) The need of drainage after cholecystectomy. HPB Surg 3: 5–10
Dubois F, Teard P, Berthelot H, Levard H (1990) Coelioscopic cholecystectomy. Ann Surg 211: 60–62
Elboim CM, Goldman L, Hann L (1983) Significance of postchole-cystectomy subhepatic fluid collections. Ann Surg 198: 137–141
Ferraina P, Danguise E, Catalano N, MorelC (1984) Bacteriología intraoperatoria de bilis (abstract). Proceedings of the second panamerican congress on infectology. Buenos Aires, Argentina, p 89
Gutierrez VP, Arozamena CJ, Perez Franco W Novo (1991) Costo/beneficios en colecistectom as electivas. Rev Argent Cirug 60: 123–126
Health Care Financing Special Report, vol. 3. Washington, D.C. Health Care Financing Administration, Office of Research and Demonstrations, June 1990
Nora PF, Vanecko RM, Brasfield JJ (1972) Prophylactic abdominal drains. Arch Surg 105: 173–176
Southern Surgeons Club (1981) A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324: 1073–1078
Van der Linden W, Kempi V, Gedda S (1981) A radionucleide study on the effectiveness of drainage after elective cholecystectomy. Ann Surg 193: 166–170
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Diez, J., Arozamena, C.J., Ferraina, P. et al. Relation between postoperative infections and gallbladder bile leakage during laparoscopic cholecystectomies. Surg Endosc 10, 529–532 (1996). https://doi.org/10.1007/BF00188401
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DOI: https://doi.org/10.1007/BF00188401