Incidence of thromboembolic complications after laparoscopic cholecystectomy: Review of the literature

The purpose of this study was to quantify the risk of thromboembolic complications after laparoscopic cholecystectomy by a survey of the literature, We reviewed 60 laparoscopic cholecystectomy series consisting of 153,832 patients. The average mortality was 0.08%. The average rate of fatal pulmonary embolism was 0.02% and total pulmonary embolism 0.06%. The average rate of reported deep vein thrombosis was 0.03%. We conclude that laparoscopic cholecystectomy is a safe procedure, and the rate of clinically evident postoperative thromboembolic complications is probably lower than after conventional cholecystectomy. A lingering bias due to the overrepresentation of young and healthy patients early in the era of laparoscopic cholecystectomy could, however, still affect these figures. An underreporting of the lesser complications is likely. The risk is not negligible, though, and some authors have recommended thromboembolism prophylaxis, although further studies are necessary to find the optimal prophylaxis strategy. The true incidence is possible to establish only by using objective diagnostic methods for surveillance.