Bowel Injury in Laparoscopic Cholecystectomy- A Surgical Challenge

Abstract

Laparoscopic cholecystectomy has become the gold standard for the surgical management of gallbladder diseases, including cholelithiasis and cholecystitis, due to its minimally invasive nature and favorable outcomes. Despite its widespread adoption and overall safety, complications can still occur. One such complication, albeit rare, is bowel injury, which can lead to significant morbidity and potentially life-threatening conditions if not promptly recognized and managed. Bowel injuries during laparoscopic cholecystectomy can arise from various mechanisms, including direct trauma from surgical instruments, thermal injury from electrocautery devices, or as a consequence of extensive adhesiolysis. The clinical presentation of bowel injury may vary, ranging from immediate recognition intraoperatively to delayed symptoms postoperatively, such as abdominal pain, peritonitis, or sepsis. Given the potentially severe outcomes, surgeons must maintain a high index of suspicion and be prepared to address these injuries promptly. In this case report, we describe a rare instance of a small bowel injury sustained during laparoscopic cholecystectomy in a 31-year-old male. We detail the intraoperative identification and management of the injury, the subsequent post-operative complications, and the successful surgical interventions that led to the patient’s recovery. This case underscores the importance of early detection and prompt intervention in managing bowel injuries during laparoscopic procedures and contributes to the existing knowledge on this critical issue.