COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY AFTER HOSPITAL DISCHARGE

In this community hospital medical center, all patients undergoing lap aroscopic cholecystectomy (LC) who had a subsequent emergency room vis it or hospital admission were reviewed to define the incidence and pre sentation of complications after hospital discharge. This unselected p opulation, which is isolated geographically, provides a useful approxi mation of mortality and morbidity after hospital discharge. Of 1231 pa tients, 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 mo st serious complications were myocardial infarction (n = 1, the only d eath), 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 wa s the most common presenting symptom (62%), and 72% (42/56) occurred w ithin 14 days, whereas, only 4% (15/375) patients with nonsurgically r elated complications presented within 14 days. In this study, emergenc y room visits and hospitalizations after LC occurred more commonly (35 %) than generally appreciated, were usually minor, and were not relate d to the operative procedure, but serious late surgical complications occasionally appeared weeks to months postoperatively.