CASE REPORTS   

Chirurgia 2014 February;27(1):39-41

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: Italian

Intrahepatic subcapsular hematoma complicating laparoscopic cholecystectomy. Case report and literature review

Corsale I., Francioli N., Rigutini M., Aloise F., Adriano Mori P., Buccianelli E.

U.O. Chirurgia Generale, Ospedale SS. Cosma e Damiano di Pescia, ASL 3 Regione Toscana, Pistoia, Italia

Laparoscopic cholecystectomy is a safe procedure but several specific complications can occur. Nevvertheless complications has different incidence and specificity of traditional surgery. Specifically haemorragic complications can occur in laparoscopic cholecystectomy usually for inadeguate haemostasis, specially of the cistic artery or from the trocars site. Authors report an unusual case developing a postoperative voluminous subcapsular hematoma of the liver developed, probably, as a result of inadequate control of a light bleeding from the orifice of epigastric access trocar. Presentations, diagnostic evaluations, treatment and possible causes are discussed on the basis of literature review. Authors refer that uncomplicated subglissonian hematomas, showing no increase in size to the instrumental examinations, can take advantages of a non-operative treatment. Subcapsular hematoma of major dimensions or complicated by infection can be subjected to percutaneous US-guided drainage. Surgical treatment is indicated in patients showing a hemodynamic unstability or a progressive increase in the size of the hematoma. Laparoscopy drainage is suitable only when there is a clear clinical status of haemodinamic stability.