Major Vascular Injury in Laparoscopic Cholecystectomy
Keywords:
Bleeding, complications, laparoscopic cholecystectomy, minimal invasive surgery, vascular injuryAbstract
Background: Major vascular injury (MVI) during laparoscopic cholecystectomy (LC) is a rare but veryserious complication of the procedure.
Materials and Methods: The published literatures that have reported the MVI in LC were reviewed.
The authors focused on MVI as an injury to any of the following vessels: aorta, vena cava, iliac vessels, and portal
vein.
Results: The incidence of MVI in LC varies in literatures. There is no definite consensus classification
of this complication. Inexperienced surgeons and factors related with patients and instruments constitute the
risk. However, MVI in LC can be avoided.
Conclusion: The good surgical technique, adequate training and awareness can prevent the MVI in LC.
Early recognition and proper management when dealing with this problem are keys to success and make this
operation a safe procedure.
References
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cholecystectomy. UpToDate. [online] 2010 [cited 2010 Oct
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2. Strasberg SM. Biliary injury in laparoscopic surgery: part 1.
Processes used in determination of standard of care in
misidentification injuries. J Am Coll Surg 2005;201:598-603.
3. Strasberg SM. Biliary injury in laparoscopic surgery: part 2.
Changing the culture of cholecystectomy. J Am Coll Surg
2005;201:604-11.
4. Moore, MJ, Bennett, CL. The learning curve for laparoscopic
cholecystectomy. The Southern Surgeons Club. Am J Surg
1995;170:55-9.
5. Hobbs, MS, Mai, Q, Knuiman, MW, et al. Surgeon experience
and trends in intraoperative complications in laparoscopic
cholecystectomy. Br J Surg 2006;93:844-53.
6. Geers J, Holden C. Major vascular injury as a complication
of laparoscopic surgery: a report of three cases and review
of the literature. Am Surg. 1996;62:377-9.
7. Seidman DS, Nasserbakht F, Nezhat F, et al. Delayed
recognition of iliac artery injury during laparoscopic surgery.
Surg Endosc 1996;10:1099-101.
8. Catarci M, Carlini M, Gentileschi P, et al. Major and minor
injuries during the creation of pneumoperitoneum.A
multicenter study on 12,919 cases. Surg Endosc 2001;15:566-
9.
9. Guloglu R, Dilege S, Aksoy M, et al. Major Retroperitoneal
Vascular Injuries During Laparoscopic Cholecystectomy
and Appendectomy. J Laparoendosc Adv Surg Tech 2004;
14:73-6.
10. Bacourt F, Mercier F. Injuries to the abdominal aorta during
laparoscopy. Chirurgie 1993-1994;119:457-61.
11. Battaglia L, Bartolucci R, Berni A, et al. Major vessel injuries
during laparoscopic cholecystectomy. Chir Ital 2003;55:291-
4.
12. Usal H, Sayad P, Hayek N, et al. Major vascular injuries during
laparoscopic cholecystectomy. An institutional review of
experience with 2589 procedures and literature review.
Surg Endosc 1998;12: 960-2.
13. Kaushik R. Bleeding complications in laparoscopic
cholecystectomy: Incidence, mechanisms, prevention and
management. J Minim Access Surg. 2010;6:59-65.
14. Hasson HM. A modified instrument and method for
laparoscopy. Am J Obstet Gynecol 1971;110:886-7.
15. Thiel R, Adams JB, Schulam PG, et al. Venous dissection
injuries during laparoscopic urological surgery. J Urol 1996;
155:1874-6.
16. Kane MG, Krejs GJ. Complications of diagnostic laparoscopy
in Dallas: a 7-year prospective study. Gastrointest Endosc
1984;30:237-40.
cholecystectomy. UpToDate. [online] 2010 [cited 2010 Oct
21]; Available from: URL: http://www.uptodate.com/
patients/content/topic.do?topicKey=~Ah/eWiY2.MQX
2. Strasberg SM. Biliary injury in laparoscopic surgery: part 1.
Processes used in determination of standard of care in
misidentification injuries. J Am Coll Surg 2005;201:598-603.
3. Strasberg SM. Biliary injury in laparoscopic surgery: part 2.
Changing the culture of cholecystectomy. J Am Coll Surg
2005;201:604-11.
4. Moore, MJ, Bennett, CL. The learning curve for laparoscopic
cholecystectomy. The Southern Surgeons Club. Am J Surg
1995;170:55-9.
5. Hobbs, MS, Mai, Q, Knuiman, MW, et al. Surgeon experience
and trends in intraoperative complications in laparoscopic
cholecystectomy. Br J Surg 2006;93:844-53.
6. Geers J, Holden C. Major vascular injury as a complication
of laparoscopic surgery: a report of three cases and review
of the literature. Am Surg. 1996;62:377-9.
7. Seidman DS, Nasserbakht F, Nezhat F, et al. Delayed
recognition of iliac artery injury during laparoscopic surgery.
Surg Endosc 1996;10:1099-101.
8. Catarci M, Carlini M, Gentileschi P, et al. Major and minor
injuries during the creation of pneumoperitoneum.A
multicenter study on 12,919 cases. Surg Endosc 2001;15:566-
9.
9. Guloglu R, Dilege S, Aksoy M, et al. Major Retroperitoneal
Vascular Injuries During Laparoscopic Cholecystectomy
and Appendectomy. J Laparoendosc Adv Surg Tech 2004;
14:73-6.
10. Bacourt F, Mercier F. Injuries to the abdominal aorta during
laparoscopy. Chirurgie 1993-1994;119:457-61.
11. Battaglia L, Bartolucci R, Berni A, et al. Major vessel injuries
during laparoscopic cholecystectomy. Chir Ital 2003;55:291-
4.
12. Usal H, Sayad P, Hayek N, et al. Major vascular injuries during
laparoscopic cholecystectomy. An institutional review of
experience with 2589 procedures and literature review.
Surg Endosc 1998;12: 960-2.
13. Kaushik R. Bleeding complications in laparoscopic
cholecystectomy: Incidence, mechanisms, prevention and
management. J Minim Access Surg. 2010;6:59-65.
14. Hasson HM. A modified instrument and method for
laparoscopy. Am J Obstet Gynecol 1971;110:886-7.
15. Thiel R, Adams JB, Schulam PG, et al. Venous dissection
injuries during laparoscopic urological surgery. J Urol 1996;
155:1874-6.
16. Kane MG, Krejs GJ. Complications of diagnostic laparoscopy
in Dallas: a 7-year prospective study. Gastrointest Endosc
1984;30:237-40.
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Published
2011-06-30
How to Cite
1.
Opasanon S, Akaraviputh T. Major Vascular Injury in Laparoscopic Cholecystectomy. Thai J Surg [Internet]. 2011 Jun. 30 [cited 2024 Nov. 23];32(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227227
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