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Iatrogenic Duodenal Injury in Laparoscopic Cholecystectomy: A Fatal Complication

Mohit Sharma, Associate Professor, Dept. of Surgery, Sri Guru Ram Das University of Health Sciences, Vallah, Amritsar, Punjab 143501, India. , Mohit Sharmaa , Rachhpal Singhb

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New Indian Journal of Surgery 9(2):p 161-165, March - April 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.9

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Abstract

Introduction: Duodenal injury during laparoscopic cholecystectomy is rare but associated with significant morbidity and mortality.

Methods: This study is a retrospective review of prospectively collected database of patients with postcholecystectomy complications. The study analysed 5 cases of duodenal injury secondary to laparoscopic cholecystectomy and managed by surgical team of our unit.

Results: Mean age of these 5 patients was  54.6 (45-65yrs) out of which 3 were males and 2 females. One case was dealt by immediate intraoperative duodenal repair on recognition of the injury. In other 4 cases, mean interval to re-surgery was 4.8 days. These 4 patients presented with septicaemia with peritonitis. Duodenorapphy with omental patch was done in 3 cases. Tube duodenostomy with feeding jejunostomy was done in one case. 4 out of 5 cases died due persistent sepsis and multiorgan failure. One patient survived with uneventful outcome.

Conclusion: Though rare, duodenal injury secondary to laparoscopic cholecystectomy is potentially a fatal complication. Early diagnosis and prompt management may minimize morbidity and mortality.

 

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.9

Keywords

Complications; Cholecystectomy; Duodenal Injury; Duodenorapphy; Laparoscopic.

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