Intra and Postoperative Complications of laparoscopic Surgery and their Management in General Surgical Practice in a Tertiary Hospital

Résumé

Introduction: Any new technique is associated with the development of new complication. The evolution of laparoscopy from a diagnostic tool to a modality for major surgical procedures has been rapid and represents one of the most important surgical advancements in the past 30 years, owing to many advantages for patients in terms of smaller scar, less post operative pain and quicker recovery. Despite the relative safety of laparoscopic techniques, inadvertent serious injuries to bowel, bladder and vascular structures do occur. Therefore, the need has arisen to study the various complications and their management inherent in this technique. The objective was to determine percentage of complications in laparoscopic surgeries of abdomen and also to study their management. Methods: This retrospective observational study was carried out Inpatients of Jalalabad Ragib Rabeya Medical College hospitals undergoing abdominal laparoscopic surgeries from January 2020 to December 2020 who are above 16 years of age. Total 179 patients who undergoing elective or emergency surgeries or diagnostic laparoscopy for acute/Recurrent appendicitis, Gallbladder diseases, hernia repair and Others were selected from different surgical units of this hospital. Demographic information, clinical findings, intra operative and postoperative findings will be noted. Follow up of the patient is done for 4-6 weeks. Result: Out of the 179, 45(25.14%) were male patients and 134 (74.86%) were female patients, age group ranging between 16-80 years. 25 patients (31.65%) showed Gallbladder Perforation, twelve (15.19%) showed bile leak. 1 patient (1.88%) had laparoscopy converted into open procedure due to the intraoperative complications. Statistically significant impact was noted on the outcome of surgery due the complication that patient underwent during the study. Conclusion: Laparoscopy is a safe, effective and well tolerated procedure if conducted in the skilled and experienced hands. The morbidity and mortality are dependent on age, general condition, presence/ absence of comorbidities and hence preoperative thorough work up is imperative. Large proportions of these complications occur during the initial learning curve of the inexperienced laparoscopic surgeon.