Complications after Laparoscopic Cholecystectomy: A Review of 183 Cases in Ahwaz

Laparoscopic procedures have gained a wide acceptance as treatment of choice for many common surgical procedures such as cholecystectomy. With this new technique, not only did the era of minimal invasive surgery begin, but also the spectrum of complications changed. However, this technique is not devoid of side effects. The aim of this study was to evaluate the patient's complaint and to evaluate the effectiveness medications used to control these problems. We retrospectively, studied the patient files that underwent laparoscopic Cholecystectomy by our team over a fifteen month period (September 2003 to December 2004) for required data, which included post-operative pain, nausea and vomiting. One hundred eighty three patients were included in the study. Sixty nine patients (37.7%) complained from abdominal and back pain. In 31 cases (45%) intramuscular injection of a NSAID (Tramadol) with mean dose of 167.5 mg was sufficient while in remaining 38 cases additional intravenous administration of pethidine was needed. In these cases, mean dose of 50 mg of pethidine was administered. In 29 cases nausea (without vomiting) were reported while there were 14 reports of vomiting which was effectively controlled by metochlopromide. Other complaints were fever (6 cases) and seroma from the trocar inserting site (one case). The mean duration of hospitalization was 28 hours (12-48 hrs) which was significantly longer in complicated cases. In our experience, abdominal pain, nausea and vomiting were the most frequent complaints during post operative period. Although in these cases hospitalization period was significantly longer in comparison with uncomplicated cases (p<0.01). The routine use the intramuscular tramadol was not effective in 55% of the patients, in nausea and/or vomiting cases intramuscular metochlopromide was adequate. These data support further research on more effective ways for manage these complications.