Laparoscopic cholecystectomy: experience at a tertiary level hospital (original) (raw)
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Laparoscopic Cholecystectomy: An Early Experience at A Tertiary Care Hospital in Islamabad
Journal of Community Medicine and Public Health Reports, 2020
Background: Laparoscopic Cholecystectomy first introduced in 1987, is becoming more and more popular and now it has become gold standard in symptomatic gallstone disease. The current descriptive study is carried out in Department of General Surgery, Ayub Teaching hospital, Abbottabad to evaluate the result of Laparoscopic Cholecystectomy in symptomatic gallstones disease in our set up with special emphasis on complication rate, morbidity and mortality. Methods: The data of all patients who underwent Laparoscopic Cholecystectomy form January to December 2007 was entered in standardized proforma and analysed on SPSS 10. Results: Out of 60 patients, 51 (85%) were female and 9 (15%) were males; the age range from 17 to 65 years mean age being 40.30 years, majority were in age 30-40 years group. Two (3.3%) patients had bile leak, 1 (1.3%) patient developed port site wound infection 1 (1.3%) patient developed collection in pouch of Morrison and in 1 (1.3%) patient stone were recovered from the epigastric port site wound. There was no bile duct or colonic injuries. The conversion rate was 5%. There was no mortality. Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment for gall stone disease and is up to the accepted standard in our set up as compared to national and international data.
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020
Cholelithiasis is one of the most common surgical conditions requiring intervention worldwide. Since its introduction nearly four decades ago, laparoscopic cholecystectomy has become the gold standard of treatment for gallstone disease AIM: To critically evaluate our experience of laparoscopic cholecystectomy in a tertiary care centre of eastern India. MATERIALS AND METHODS: Hospital based observational study on 180 patients subjected to elective laparoscopic cholecystectomy with features of gall stone disease and meeting the inclusion and exclusion criteria. RESULTS: Our conversion rate of 10% is somewhat higher than that reported in any other series. This probably reflects that few of our surgeons are in their early learning curve. This can be reduced with the experience of the surgeons. A bile duct injury rate of 0.5% compares favourably with an incidence of 0-1% in several large series. Overall complication rate of 5.5% also compares favourably with an incidence of 1.6-8.6% in s...
An Audit of Laparoscopic Cholecystectomy
Objective: To evaluate the morbidity and mortality rates in laparoscopic cholecystectomy. Material and Methods: This retrospective descriptive study was carried out in surgical "D" ward Khyber Teaching Hospital, Peshawar, from December 2012 to December 2014 in which 233 patients after fulfilling the inclusion and exclusion criteria with symptomatic gallstones disease were enrolled. Demographics, complications of surgery and conversion to open were reviewed from clinical notes and noted on a pre-designed proforma. Data were analyzed using SPSS version 16 and results compared with other studies. Results: A total of 233 patients were studied during the audit period. Of these 41(17.6%) were males and 192(82.4%) were females. Mean age of patients was 36.56±11.32 years. Mean operating time was 56.57±13.95 minutes. Complications encountered during the study include conversion to open cholecystectomy 2 (0.9%), epigastric port site bleeding 3 (1.3%) and port site infection 6(2.5%). Mean hospital stay was 3.37±2.27 days. There were no cases of umbilical port hernia, bile duct or colonic injury. No mortality was observed in our study. Conclusion: The various data collected during the audit suggest that the results of laparoscopic cholecystectomy carried in our unit are satisfactory.
Laparoscopic Cholecystectomy: An Initial Clinical Experience at Faridpur District
Journal of Current and Advance Medical Research, 2015
Background: Laparoscopic cholecystectomy quickly emerged as an alternative to open cholecystectomy. However its safety, efficacy, and morbidity have yet to be fully evaluated. Objective: The purpose of the present study was to determine the efficacy and safety of laparoscopic cholecystectomy Procedure in the removal of gall bladder stones at Faridpur district-one of the remote district of Bangladesh. Methodology: A prospective, nonrandomized, open label Consecutive study was carried out at Faridpur district using laparoscopic cholecystectomy (LC) procedure for the symptomatic treatment of Gall bladder stones. For this purpose a total number of 145 patients having conclusively diagnosed as gall bladder stones were enrolled. LC procedure was performed by North American technique-a well established and standard procedure described earlier for the purpose. The key variables studied were average operating room time, condition of the gall bladder, the presence or absence of stones, the character of stones, post-operative complicates and duration of hospital stay. Result: The study revealed that among 145 patients 83.4% were female with an average age of 40.3 years. The average operating time required was 130 minutes. Gall bladder was thickened but was free from adhesion in 96.5% cases and stones' only 3.45% patients needed open method due to fibrosis and adhesion of the gall bladder with omentum and gut. The duration of hospital or clinic stay following LC was 3.5 days. Evidence of infection like fever, pain etc. was seen only in 2.75% cases. Bleeding was present in 2.06% cases. This was corrected after blood transfusion. No injury to the common bile duct or any of the bile duct or any of the blood vessels was observed. Similarly no evidence of malignancy was seen in any of the gall bladder removed. Conclusion: The present study concludes that laparoscopic cholecystectomy is a safe, minimal invasive, cost-effective and safe procedure for the symptomatic treatment of gall bladder stones.
Pakistan Armed Forces Medical Journal, 2020
Objective: To compare the morbid anatomy and iatrogenic problems and complications encountered during laparoscopic cholecystectomy (LC) in both genders. Study Design: A cross sectional analytical study. Place and Duration of Study: The study was conducted at Pakistan Air Force Hospital, Islamabad, from May 2017 to Jan 2019. Methodology: All patients who underwent LC during our study period were included in the study. A predesigned proforma was used to record data. The cases were divided into two groups based on gender. The parameters studied for each group included appearance of gallbladder, intra operative bile leakage, requirement of hemostatic procedure, spillage of stones, multiplicity of stones i.e. single vs. multiple, operative time and need of drain placement. Results: A total of 120 patients were included in the study. There were 21 (17.5%) male and 99 (82.5%) female subjects. The mean age was 43.66 ± 13.8 years with range of 11-74 years. Normal looking gallbladder was more...
Laparoscopic cholecystectomy at the Korle Bu Teaching Hospital, Accra, Ghana: An initial report
West African Journal of Medicine, 2011
BACKGROUND: Laparoscopic cholecystectomy (LC) the preferred treatment for gallstones was not available in Ghana until 2005. OBJECTIVE: To report experience from Ghana of laparoscopic cholecystectomy in the treatment of galestones. METHODS: In a prospective study of patients with gallstones, information was obtained on demography, duration of various stages of the operation, analgesia and complication of patients with gallstones. All patients had general anaesthesia using endotracheal intubation, muscle relaxant and intermittent positive pressure ventilation. A standard four-trocar technique and maximum pneumoperitoneum pressure of 14mmHg were maintained during surgery. RESULTS: There were 50 women and two men aged 17-72 years (mean 44.2 years). All had symptomatic gallstones treated by interval LC. The main indications were biliary colic 23(44%) and previous cholecystitis 15(29%). There were scars from previous abdominal surgery in 22 (42%), mainly pfannenstiel. The Verres needle was used to obtain pneumoperitoneum in 40 (77%). Only one patient (1.9%) had the operation converted to open cholecystectomy. Most patients, 47/51 (92%), were discharged in 24 hours. The mean durations of various stages were: anaesthesia (110 minutes), pneumo-peritoneum (67.5 minutes) and reverse trendelenburg (47.8 minutes). The mean operating time reduced from 81 to 68 minutes in the last 20 patients. Complications were sore throat 11(21.6%), infection of the umbilical wound 3(5.9%), right shoulder tip pain (3; 5.9%) and bile leak 1(2%). There was no peri-operative mortality. CONCLUSION: Elective laparoscopic cholecystectomy can be performed with good results in patients with symptomatic gallstones in Accra. WAJM 2010; 29(2): 113-116.
Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study
2020
Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder. It is estimated that approximately 90% of cholecystectomies in the United States are performed using a laparoscopic approach. The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital. Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 m...
Annals of Saudi medicine
Laparoscopic cholecystectomy (LC) is now a common method of treating symptomatic gallstones, and it is increasingly being requested by the informed general public. Our aim was to evaluate the role of LC for cholelithiasis and to establish its outcome and the effect of gender on the results. Between September 1994 and June 1999, all patients who underwent LC for cholelithiasis were retrospectively reviewed. They were classified as having acute or chronic cholecystitis (AC or CC). There were 791 patients with CC (633 females, 158 males) and 204 patients with AC (124 females, 80 males). Conversion to open cholecystectomy was needed in 0.76% and 11.8% of the patients with CC and AC, respectively (P<0.00). Four percent of the female patients with AC needed conversion as compared to 23.8% in the males (P<0.00). The low conversion rate in CC limited gender comparison. Median operation time in the patients with CC was 53+/-16 minutes as compared to 74.5+/-35.7 minutes in those with AC...
Experience in laparoscopic cholecystectomy in Nobel Medical College, Nepal
Heart, Vessels and Transplantation, 2019
Objective: A laparoscopic cholecystectomy (LC) is the treatment of choice for gallbladder diseases. The aim of this study is to analyze laparoscopic cholecystectomies performed by a single surgeon over 8 years at Nobel Medical College Teaching Hospital and Research Centre Pvt. Ltd. of Biratnagar, Nepal (NMCTH). Methods: We performed a retrospective analysis of 7557 patients that underwent a LC by a single surgeon, from October 2010 to July 2018. We divided it into 3 groups that include data of every three years. Results: The hospital stay, operation time and conversion rates were decreased by years of experience. Female patients outnumbered male (M:F=1:3.7) patients in this study. The hospital stay (3 days), operation time (21 min), conversion (0.3%) and complications (1.9%) rates decreased from Group 1 to Group 3 (p<0.05). Conclusion: As surgical experience increased with a rising number of cases, the conversion rate, complications, hospital stay and mean operation time decrease...