Publication:

Troublesome gallbladder fossa bleeding during laparoscopic cholecystectomy: case series with review of literature

Gall bladder fossa bleeding is an uncommon but significant complication of laparoscopic cholecystectomy (LC). Effective laparoscopic control of such bleeding is essential to avoid conversion to open surgery. This retrospective case series was conducted in the Department of General Surgery and Advanced Laparoscopic Surgery, Dr. L. H. Hiranandani Hospital, Powai, Mumbai, Maharashtra, India. The study included patients who developed gall bladder fossa bleeding not controlled by conventional measures, during LC between 2013 and 2023. Hospital electronic medical records (EMR) and operative notes were reviewed to identify eligible cases. A total of three patients were included in the study. Data were extracted using a structured case record proforma and included patient’s age, sex, diagnosis, intraoperative occurrence of gall bladder fossa bleeding, and the surgical technique used for hemostasis. All patients were managed with laparoscopic gall bladder fossa suturing for control of bleeding. The effectiveness of the technique was assessed based on achievement of hemostasis, need for conversion to open surgery, and intraoperative outcome as documented in operative records. A total of three patients who developed gall bladder fossa bleeding during LC between 2013 and 2023 were included in this case series. The mean age of the patients was 47.3 years (range: 39-57 years). Two patients (66.7%) were male and one patient (33.3%) was female. All cases were diagnosed intraoperatively and were managed successfully with laparoscopic gall bladder fossa suturing. Hemostasis was achieved in all patients (100%) without the need for conversion to open surgery. No intraoperative complications related to the suturing technique were reported in any of the cases. Laparoscopic gall bladder fossa suturing proved to be an effective and safe technique for achieving hemostasis in all patients, with no need for conversion to open surgery and no associated complications. This method may serve as a useful option for controlling persistent gallbladder (GB) bed bleeding when conventional hemostatic measures are ineffective.