ABSTRACT
The common intraoperative issues associated with laparoscopic cholecystectomy (LC) are bleeding, bile leak, bile duct injury and stone spillage. The common sites of bleed during LC are: Gallbladder bed, cystic or right hepatic artery, port site and occasionally major injury to the portal vein or terminal part of the middle hepatic vein in the gallbladder bed. Bile leak can be due to injury to the subvesicle duct or the common bile duct. The source of leak must be identified and appropriate measures taken. Stone spillage needs thorough cleaning and the possible removal of all stones. Conversion to open cholecystectomy can be elective or forced. Forced conversion is to manage or rule out any suspected complication during surgery.
