Septic complications of gallbladder lacerations during laparoscopic cholecystectomy

The iatrogenic gallbladder perforation with bile and, eventually, gallstones loss in the peritoneal cavity happens in the laparoscopic cholecystectomies more frequently than in the laparotomic ones. The authors have reviewed their experience and recent bibliography with the aim to clarify factors that increase risks for this adverse effect; 579 patients subjected to laparoscopic cholecistectomy: in 81 cases (13.98%) the intra-peritoneal perforation of the gallbladder wall has happened, in 26 associated to gallstones loss; 12 of these last have developed abdominal wall infections. No case of intra-peritoneal abscess was observed. The Authors believe to be proper to select patients with the clinical and instrumental evaluation. They identify emergency and flogosis as risk factors for the perforations, as well the systemic illnesses for sepsis. They emphasize the role of antibiotic prophylaxis in the high risk subjects.