A Prospective Study of Cholecystectomy in a Single Surgical Unit (original) (raw)
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Surgical Endoscopy, 2013
Background The purpose of this study was to compare length of stay, as one of the efficacy indicators, and effectiveness, in terms of operative complications and mortality, between laparoscopic (LC) and open cholecystectomy, and to verify the 10-year temporal trends in the application of the LC technique in a large regional population. Methods This was a retrospective cohort study based on 73,853 hospital discharge records of cholecystectomies for gallstone disease (GD) in residents of the Veneto from 2001 to 2010, at both public and accredited private hospitals. The data are from a regional administrative database. The main epidemiological rates calculated, and expressed per 100,000 residents, were the cholecystectomy rate (CR) for gallstones by surgical technique (laparoscopic or open surgery), and the in-hospital mortality rate (MR), considered as the in-hospital MR regardless of the specific cause of death. Results The CR was 139.7 higher in females, with a male-to-female ratio of 1:1.5. LC was performed more frequently in females than in males and in younger than in older patients. From 2001 to 2010, there was a significant linear rising trend in the use of LC, in fact during the period considered, the use of laparoscopic surgery increased significant (v 2 trend: 316,917; p \ 0.05), reaching 93.6 % of surgical procedures for gallstones during the year 2010. Conclusions There are still some age-and gender-related disparities in its usage, although LC is an increasingly widely applied, as effective procedure.
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.
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...
Background: Gallstone disease is a major health problem worldwide particularly in the adult population. Previously complicated gallstone disease was considered to be a contraindication for laparoscopic cholecystectomy. This initial reluctance has slowly evaporated as a result of increasing expertise. The aim of study was to compare the outcome of laparoscopic with open cholecystectomy in patients with complicated gallstone disease. Material & Methods: This study was carried out in Surgical Unit-IV, Liaquat University Hospital Jamshoro, from January 2008 to December 2009. One hundred patients were divided in two groups of 50 each; Group A for open Cholecystectomy (OC) and group B for laparoscopic cholecystectomy (LC). Data was analyzed using SPSS software. Results: Out of 100 patients there was female preponderance with male to female ratio of 1:1.5 in group A and 1:3.5 group B. The mean age was 41.28±12.30 years for group A and 38.44±13.50 for group B. Ultrasound findings revealed was single stone [13(26%) patients in OC vs 10 (20%) patients in LC group], multiple stones [37(74%) patients in OC vs 40 (48%) patients in LC group], Impacted stone [15(30%) patients in OC vs 18 (36%) patients in LC group], Thick wall gallbladder [26(52%) patients in OC vs 25(50%) patients in LC group], empyma [6(12%) patients in OC vs 8(16%) patients in LC group], mucocele [3(6%) patients in OC vs 5(10%) patients in LC group], contracted [7(14%) patients in OC vs 8(16%) patients in LC group]. Operative time range 30 minutes to 90 minutes in both groups. The mean time in OC group was 54.90±15.90 minutes and LC group was 48.30±12.96 minutes (p 0.026). No mortality was reported in this series. Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment of complicated gallstone disease. KEY WORDS: Laparoscopy, Cholecystectomy, Gallstone.
The Effects of Laparoscopic Cholecystectomy a Cross-Sectional Study
Zenodo (CERN European Organization for Nuclear Research), 2022
This paper aims to know the type of effects after laparoscopic cholecystectomy. The behaviour of surgical treatment of gallbladder diseases was determined by laparoscopic cholecystectomy. A cross-sectional study was conducted in different hospitals in Iraq, and all patients who were exposed to gallbladder disease were tributaries of surgical treatment from February 2019 to April 2020; and in this study, 110 were collected and divided into two groups (single incision laparoscopic cholecystectomy 50 patients) (conventional laparoscopic cholecystectomy 60 patients). The main risk factors for laparoscopy in our study were those related to the origin of ischemic heart disease with a total of 35 patients (31.8%) in both groups, heart valve disease and Arrhythmia in both groups for 22 patients with (20%). The Laparoscopic Cholecystectomy Visual Rating Scale has been relied on for the purpose of Data about pain and nausea-vomiting. The results showed a high severity for patients who underwent single incision laparoscopic cholecystectomy at all levels and a higher death rate for four patients compared with two patients for conventional laparoscopic cholecystectomy. We conclude from this study that conventional laparoscopic cholecystectomy is currently considered the gold standard for the purpose of obtaining fewer complications as conventional laparoscopic cholecysectomy, and it is the preferred method for doctors to laparoscopic cholecystectomy.
Gut, 1993
The pre and postoperative symptoms and outcome after surgery in patients with symptomatic gall stone disease were evaluated by a detailed self administered postal questionnaire. The survey was conducted in two groups: 80 patients treated by laparoscopic cholecystectomy and an age matched cohort of patients who had conventional open cholecystectomy. The overall response rate on which the data were calculated was 76%. Symptomatic benefit ratios accruing from the surgical removal ofthe gall bladder were calculated. The symptoms that were relieved by cholecystectomy were nausea (0.98), vomiting (0-91), colicky abdominal pain (0.81), and backpain (0.76). Flatulence, fat intolerance, and nagging abdominal pain were unaffected as shown by a benefit ratio of 0 5 or less. Relief of heartburn (39/49) outweighed the de novo development of this symptom after cholecystectomy (7/49), resulting in a benefit ratio of 0*65. Postcholecystectomy diarrhoea occurred in 21/118 patients (18%): 10 after open cholecystectomy and 11 after laparoscopic cholecystectomy. The type ofsurgical access did not influence the symptomatic outcome but had a significant bearing on the time to return to work or full activity after surgery (laparoscopic cholecystectomy two weeks, open cholecystectomy eight weeks, p=000001). In the elderly age group (>60 years), significantly more patients (29/30) regained full activity after laparoscopic cholecystectomy when compared with the open cholecystectomy group (16/22), p=OOOl. The patient appreciation of a satisfactory cosmetic result was 72% in the open group compared with 100% of patients who were treated by laparoscopic cholecystectomy (p=0 0017). Despite the persistence or de novo occurrence of symptoms, 111/117 patients (95%) considered that they had obtained overall symptomatic improvement by their surgical treatment and 110/118 (93%) were pleased with the end result regardless of the access used.
Laparoscopic cholecystectomy: experience at a tertiary level hospital
Journal of Ayub Medical College, Abbottabad : JAMC
Cholecystectomy is the most frequently performed abdominal operation and currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in 90% cases of symptomatic gallstones in USA since 1992. The aim of the study was to determine results obtained with LC at our setup. This observational case series study was conducted in department of General Surgery, Combined Military Hospital, Rawalpindi, from August 2009 to August 2011. The study participants were patients of both gender aged 14-75 years undergoing LC. Surgery was performed by consultant as well as resident surgeon. Demographic variables, intraoperative findings, mean operation time, hospital stay, conversion rate, morbidity and mortality were evaluated. Factors influencing rate of conversion were also studied. A total of 504 patients were included. Mean age was 42.64 years (range 14-75 years) with a female: male ratio of 3.9:1.2. Comorbidities were found in 36.7% patients. Main indication of surgery wa...
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.