Objectives

1. To highlight the broad range of early and late complications post laparoscopic cholecystectomy

2. To provide imaging pearls for correct diagnosis with potential pitfalls also illustrated

Background

Gallstone disease affects approximately 15% of adults with laparoscopic cholecystectomy being the surgical procedure of choice for symptomatic patients. In the UK, over 60,000 are performed annually and although complication rates are low there is still an array of both early and late complications which can arise. The radiologist should be able to correctly identify these complications so that appropriate subsequent management can be implemented.

Imaging findings OR Procedure findings

We present a multimodality pictorial review of imaging findings for a broad range of early and late complications. Early complications include: pseudoaneurysms presenting with acute haemorrhage, bile duct inadvertent clip placement and bile duct leaks.

Late complications include: migrated surgical clips, spilled gallstones with abscess formation, common bile duct stones, cystic duct remnant syndrome, tumour seeding and port site hernias.

Potential pitfalls such as absorbable haemostatic agents mimicking abscess formation is also illustrated with the key imaging features highlighted.

Conclusion

Although the complication rates are low, radiologists should be aware of and be able to identify the most appropriate imaging modality for the range of potential complications that can occur both peri-operatively and further along the patient's post-operative journey. Early and appropriate diagnosis allows for timely management and optimal patient care.