Major Risks In Laparoscopic Cholecystectomy: A Single Centre Five Years Experience

Laparoscopic cholecystectomy has become the standard treatment for symptomatic gallstones due to its numerous advantages. However, the procedure is not without risks, with significant intraoperative complications such as vascular and biliary duct injuries that can negatively impact surgical outcomes. Over time, several risk factors have been identified, including male gender, advanced age, comorbidities, and a his-tory of previous abdominal surgery. An essential preventive strategy is the early recognition of situations where laparo-scopic completion may be unsafe, allowing for timely adoption of bail-out procedures, such as conversion to open surgery or subtotal cholecystectomy. This study presents the five-year experience of the General Surgery Department at Colentina Clinical Hospital, Bucharest, Romania, evaluating the incidence of in-traoperative complications in laparoscopic cholecystectomy and the associated risk factors, with a comparison to the current literature. Our findings indicate that male gender, prior abdominal surgery, and acute cholecys-titis are significantly associated with an increased risk of intraoperative complications. The most frequently encountered complications were access-related incidents and minor vascular injuries, with biliary duct injuries occurring rarely. A limited number of cases required conversion to open surgery, while no subtotal cholecystectomies were performed as a preventive approach. Laparoscopic cholecystectomy remains a safe and effective procedure for the treatment of symptomatic gallstones when performed by experienced surgeons, supported by thorough preoperative planning and risk assessment. Surgeons should discuss the possibility of conversion to open surgery or the need for subtotal cholecystectomy with patients preoperatively, emphasizing that these decisions represent safer options rather than surgical failures. The appropriate selection of a bail-out procedure should be viewed as a preventive strategy aimed at minimizing the risk of major complications and optimizing patient outcomes.