Laparoscopic cholecystectomy in obese patients

Medical (General Surgery)

Laparoscopic cholecystectomy became widely accepted as the preferred treatment for cholecystitis and gallstone disease. This innovative method not only ushered in a new era of minimally invasive surgery, but it also altered the range of potential problems. Our article discusses laparoscopy-related complications, including procedure-related issues and access injuries. The literature is reviewed in accordance with typical accidents. The primary subjects of this article (still on a level of 0.2%–0.8%) include pneumoperitoneum setup (morbidity up to 0.2%); bleeding from trocar sites and vascular injury (mortality up to 0.2%); and biliary leaks and bile duct injuries. An overview of the most often described categories of bile duct injuries is provided, along with a graphic summary of the aetiology, diagnosis, and therapy. Lastly, the topic of bowel injuries—a unique consequence of laparoscopy with an incidence of up to 0.87%—is covered. Nowadays, laparoscopic cholecystectomy is the go-to procedure for any gallstone condition. However, there are still several questions that are being debated: What are the best course of action? More importantly, is the laparoscopic method actually better than the open treatment based on evidence-based medicine standards? What should we do if choledocholithiasis is occult? Does the idea of treating silent gallstones need to be updated in light of laparoscopic cholecystectomy, and is intraoperative cholangiography required?

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