ABSTRACT
Laparoscopic cholecystecmy is the preferred method for removing the Gall bladder. The most frequent intro-operative complications are by for related to the biliary tract: wounds, section. From September 1995 to August 2001, the authors have realized 1570 cases of laparoscopic cholecystectomy. There were 3 lesions of the common bile duct. Most of those complications are directly proportional to the operators experience. Their prevention depends on a perfect technics, understanding of the mechanisms and no hesitation in converting to conventional laparotomy whenever difficulties are encountered
ABSTRACT
A retrospective consecutive study was made of 3000 surgical wounds. All wounds were examined for ten days after operation. The overall infection rate of surgical wound infection [SWI] was 3,53%. SWI lengthed significantly duration of hospital stay [12 days vs 4 days, p<10-6]. Monovariate analysis had shown as significantly risk factors: diabetes [12,26% vs 5,49%, p<10-6], emergency operation [5,64% vs 2,43%, p<10-3], acute appendicitis [24,53% vs 13,06%, p<10-3], biliary emergencies [10,37% vs 4,73%, p<10-3], operations achieved by young surgeons [5,55% vs 2,83%, p<10-3], choledocotomy [10,38% vs 5,46%, p<0.05], colorectal resection [8,50% vs 4,14%, p<0.05], open laparotomy versus laparoscopy [19,81% vs 1,89%, p<0,05] and operating time [148mn vs 104 mn, p<0.05]. Logistic regression showed that diabetes [p=0.00488], biliary emergencies [p=0,0016], seniority of surgeon [p=0.0023], type of skin incision [p=0.0196] and operating time [p=0,0005] were the independent risk factors for surgical wound infection