Foley catheter tamponade-an effective and first line management of epigastric port site bleed in laparoscopic cholecystectomy: a study of 23 cases over 20 years

Abstract

Background: To study a simple yet effective surgical technique of management of epigastric port site bleed and how to prevent such an incidental surgical accident in patients undergoing laparoscopic cholecystectomy. Methods: This is a prospective pilot study done during last 20 years in patients undergoing laparoscopic cholecystectomy, who accidentally developed epigastric port-side bleed. A 22 Fr inflated Foley catheter under traction was used to control the bleeding. After an average 24-48 hours of traction tamponade, the catheter was deflated and removed accordingly. Results: The 23 patients had a complication of epigastric port bleeding, in which Foley’s catheter tamponade was used. In 22 (99.65%) cases, bleeding was controlled effectively with Foley catheter tamponade. Only in 01 patient bleeding could not be controlled with the usually applied traction, so an enhanced traction was introduced, with our indigenously fabricated external contraption. No case required wound exploration or any other sophisticated means of controlling epigastric port site bleed. There was no mortality. Conclusions: One of the most common complications of laparoscopic surgery is epigastric port site bleeding, which is an avoidable complication, provided proper procedure is followed in establishing this port.