COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY AFTER HOSPITAL DISCHARGE

In this community hospital medical center, all patients undergoing laparoscopic cholecystectomy (LC) who had a subsequent emergency room visit or hospital admission were reviewed to define the incidence and presentation of complications after hospital discharge. This unselected population, which is isolated geographically, provides a useful approximation of mortality and morbidity after hospital discharge. Of 1231 patients, 800 (65%) had no subsequent hospitalization or emergency room visit within a 6-32-month follow-up, whereas 431 (35%) did. Fifty-six (4.6%) patients had surgical complications related to their LC. The most serious complications were myocardial infarction (n = 1, the only death), common duct stricture (n = 2), retained common duct stone (n = 2), cystic duct leak (n = 2), subhepatic fluid collection or abscess (n = 3), pancreatitis (n = 3), and pulmonary (n = 5). Abdominal pain was the most common presenting symptom (62%), and 72% (42/56) occurred within 14 days, whereas, only 4% (15/375) patients with nonsurgically related complications presented within 14 days. In this study, emergency room visits and hospitalizations after LC occurred more commonly (35%) than generally appreciated, were usually minor, and were not related to the operative procedure, but serious late surgical complications occasionally appeared weeks to months postoperatively.