Choice of surgical tactics for the correction of early complications after laparoscopic cholecystectomy

Objective: A comprehensive analysis of factors influencing the choice of surgical tactics in the correction of early complications after laparoscopic cholecystectomy. Materials and Methods: Between 2015 and 2025, data from 70 patients who underwent laparoscopic cholecystectomy and presented with signs of early postoperative complications were analyzed. Of these, 24 (34.3%) were men and 46 (65.7%) were women. The study group included 40 patients in whom complications were corrected using relaparoscopic surgery and modern laparoscopic instruments. The control group included 30 patients who underwent traditional treatment using open surgery and conservative therapy. Results: Relaparoscopy resulted in clinical recovery in 95% of patients in the study group, shortening the duration of hospitalization and the inflammatory response. The most common complications were: bile leakage (14 cases, or 20%), abscesses and infiltrates (9 cases, or 12.8%), bile peritonitis (7 cases, or 10%), and intra-abdominal bleeding (6 cases, or 8.6%). Dynamic monitoring of liver biochemical parameters (ALT, AST, bilirubin) and inflammatory markers (GGT, interleukin-6, D-dimer, procalcitonin) showed statistically significant improvement in patients in the study group as early as 3-5 days after relaparoscopy, while in the control group, changes were less pronounced and delayed. A direct relationship was established between the level of intraoperative complexity according to the Cuschieri scale and the frequency of postoperative complications: with low complexity, complications were observed in only 16.6% of cases, while with high complexity, their frequency reached 88.5%. Conclusion: Early diagnosis of complications based on clinical observation, ultrasound, and laboratory parameters significantly reduces the risk of severe complications. Relaparoscopy is the preferred method for correcting most early complications after laparoscopic cholecystectomy due to its high efficacy, safety, and minimal invasiveness. The use of the Cuschieri intraoperative complexity scale allows for an objective assessment of the risk of complications and the prognosis of the postoperative course.