ABSTRACT
Introduction: Splenectomy addresses the role of the spleen in hematological disorders particularly those ofcellular sequestration and destruction and antibody production. Splenectomy is indicated in specific cases ofanemia.Material and methods: The study was conducted in the department of General and Minimal Invasive Surgery incollaboration with the department of Clinical Hematology, Sher-I-Kashmir Institute of Medical Sciences, Srinagarfrom Jan 2012 to Jan 2016.The study included 33 patients The patients were studied in regards to thevariables1.clinical and demographic information. 2.surgical findings.3.preoperative and post operativehaematological profile.4.immediate and late complications.5.hospital stay6.persistence of disease.Result: In our study, out of 33 patients, laparascopic splenectomy(LS) was performed on 19 patients(57.6%) and14 underwent open splenectomy(OS).. Mean age was 28.89 years in LS group.and 36 years in OS group. Malefemale ratio was 4/15 in LS and 3/11 in OS. Mean operation time was 107.5 minutes in LS and 80.7 minutes in OS(pvalue <.001). Mean intraoperative blood loss was significantly lower for LS vs OS (76.43 mL vs 133.57 mL; P =.003). There was no statistical significant difference in complications between the two groups. Also, There wasno significant difference between LS and OS in terms of remission rates.Conclusion: Laparoscopic splenectomy is a safe and effective procedure in experienced hands. It is superior withregard to hospital stay, operative blood loss, postoperative pain and cosmesis as compared to Open Splenectomy.
ABSTRACT
As the number of surgeons performing laparoscopic cholecystectomy(LC), a rigorous evaluation of the safety of LC is waranted. It is essential to determine the extent of the difference in morbidity and mortality when compared with open cholecystectomy(OC). To compare the complications occurring in the patients undergoing L.C as compared to those undergoing open cholecystectomy. In a study conducted over a period of 8 years, 400 patients who underwent LC were compared to 400 patients who had undergone OC. The two groups were compared with respect to complication (severity grade 1-4), hospital stay and time required to return to work. (using the student ‘t’ test). The overall complication rate in both the groups was 4.8%. In LC group, the rate of grade 1, grade 2a and grade 2b complications were 2.3%, 0.3% and 2.3% respectively and in OC group it was 4%, 0% and 0.8% respectively. It means that grade 1 complications were 1.89 times higher in open cholecystectomy group as compared to LC group and grade 2b complications are 3.04 times higher in LC group as compared to OC group, though the variations are insignificant statistically. There was 0% mortality in both the groups. Postoperative hospital stay and time taken to return to work were less with LC group. Laparoscopic and open cholecystectomy were found to be comparable procedures in terms of complication for the treatment of gall stone disease and LC has not been associated with any increase in untoward events.