Early endoscopic retrograde cholangiopancreatography after laparoscopic cholecystectomy can strain the occurrence of trocar site hernia

This study reports a 69-year-old, obese, female patientpresenting with a biliary leakage after laparoscopiccholecystectomy for cholelithiasis. Closure of the um-bilical trocar site had been neglected during the lapa-roscopic cholecystectomy. Early, on postoperative dayfive, endoscopic retrograde cho...

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Bibliographic Details
Published inWorld journal of gastrointestinal endoscopy Vol. 6; no. 11; pp. 568 - 570
Main Authors Sumer, Fatih, Kayaalp, Cuneyt, Yagci, Mehmet Ali, Otan, Emrah, Kocaaslan, Huseyin
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 16.11.2014
Subjects
Case Report
cholangiopancreatogra-phy
cholecystectomy
complications
Endoscopic
hernia
Laparoscopic
Postoperative
retrograde
site
Trocar
Trocar site hernia
Endoscopic retrograde cholangiopancreatography
Laparoscopic cholecystectomy
Postoperative complications
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Summary:This study reports a 69-year-old, obese, female patientpresenting with a biliary leakage after laparoscopiccholecystectomy for cholelithiasis. Closure of the um-bilical trocar site had been neglected during the lapa-roscopic cholecystectomy. Early, on postoperative dayfive, endoscopic retrograde cholangiopancreatography(ERCP) requirement after laparoscopic cholecystectomyresolved the biliary leakage problem but resulted with amore complicated clinical picture with an intestinal ob-struction and severe abdominal pain. Computed tomog-raphy revealed a strangulated hernia from the umbilicaltrocar site. Increased abdominal pressure during ERCPhad strained the weak umbilical trocar site. Emergencysurgical intervention through the umbilicus revealed anischemic small bowel segment which was treated withresection and anastomosis. This report demonstratesthat negligence of trocar site closure can result in veryearly herniation, particularly if an endoscopic interven-tion is required in the early postoperative period.
Bibliography:Fatih Sumer;Cuneyt Kayaalp;Mehmet Ali Yagci;Emrah Otan;Huseyin Kocaaslan;Department of Surgery, Inonu Uni-versity, Malatya 44315, Turkey
Correspondence to: Cuneyt Kayaalp, MD, Professor, Department of Surgery, Turgut Ozal Medical Center, Inonu University, Elazig Yolu 10. Km., Malatya 44315, Turkey. cuneytkayaalp@hotmail.com
Telephone: +90-422-3410660 Fax: +90-422-3410229
Author contributions: Sumer F contributed to surgeon of the case, planning, collecting the data and writing; Kayaalp C wrote the paper; Yagci MA contributed to the planning and critical editing; Otan E contributed to the language translation and critical editing; Kocaaslan H contributed to the surgeon of the case and collecting the data
ISSN:1948-5190
1948-5190
DOI:10.4253/wjge.v6.i11.568