Complications of laparoscopic cholecystectomy: Major adverse events and prevention strategies

Abstract

Laparoscopic cholecystectomy is widely performed for gallbladder diseases, although it remains associated with potentially serious complications. This study aimed to analyze the main procedure-related adverse events, their predisposing factors, clinical consequences, and prevention strategies. A qualitative, descriptive-analytical narrative literature review was conducted using 13 scientific publications from 2016 to 2025, including reviews, meta-analyses, observational studies, and clinical guidelines. The evidence identified bile duct injuries and hemorrhagic, vascular, visceral, and infectious complications as clinically relevant events associated with anatomical complexity, inflammatory conditions, and intraoperative technical difficulties. Achieving the critical view of safety emerged as a fundamental principle of anatomical identification, while intraoperative imaging techniques and alternative surgical approaches offered complementary options, although the certainty of the supporting evidence remained limited. Timely recognition of complications and specialized management were particularly important in complex bile duct injuries. The findings indicate that laparoscopic cholecystectomy safety depends on integrating risk assessment, meticulous anatomical identification, individualized surgical decision-making, and postoperative follow-up. These measures are essential to reducing preventable adverse events and limiting their clinical consequences.