ABSTRACT
Objective: To see feasibility, per operative difficulties and overall results of lap: Cholecystectomy in our newly established minimal invasive surgical setup
Study Design: Randomized Descriptive study
Place and Duration of Study: This study was conducted in Surgical Department of newly established Khairpur Medical College/ Civil Hospital Khairpur Mir's from August 2014 to May 2015
Materials and Methods: The data of all the 100 patients with the diagnosis of gall stone disease was entered in specific proforma, who were admitted at K.M.C / Civil Hospital Khairpur Mir's. The consent for laproscopic procedure was taken prior to surgery. All the base line blood and radiological investigations were done. Cardiac and general anesthesia opinion were also taken. The procedure was carried out by conventional "four port" method on scheduled elective operation list
Results: In this study male to female ratio was 1:6.1 and mean age was 38.5 years. In 52 patients gall bladder was non inflamed and callot's triangle was clear but in 48 cases various kinds of abnormalities were present. In 40% cases operative technique was modified by different means. Conversion rate remained 09%. In 56 cases operative time was 40 mints, in remaining 44 patients it was beyond 40 mints. Post operatively 26 patients developed various minor and major complications. There was no mortality in our series
Conclusion: Lap: Cholecystectomy is safe and effective procedure, applicable to any general as well as teaching hospital. Over all our results are acceptable according to the national and international studies
ABSTRACT
This comparative prospective study was conducted at the Ghulam Muhammad Mahar Medical College Hospital and Red Crescent General Hospital, Sukkur, Pakistan, for a period of two years from July 2012 to June 2014. The study included 1800 patients who underwent laparoscopic cholecystectomy for symptomatic cholethiasis. These patients were divided in to two groups. Group I included 900 patients, who underwent conventional laparoscopic cholecystectomy with the four port technique. In these patients, the gall-bladder was retrieved through umbilical port by a sterile surgical hand glove [size 6[1/2] or 7 inches] endobag. The fascial defect of 10 mm umbilical port was closed by vicryl "0" with J-shaped needle, while three 5 mm ports closed by applying steri strips. Group-II also included 900 patients. In these patients laparoscopic cholecystectomy was done by using three ports, 10 mm epigastric working port, 5 mm umbilical port for 5 mm telescope and lateral 5 mm port for assistant. The gall-bladder was retrieved through epigastric port without endobag. The results of both these techniques were collected and analyzed on SPSS version 14. The mean age of patients was 45 years. The male to female ratio was 1:3. In group-I, after laparoscopic cholecystectomy, gall-bladder was retrieved safely through 10 mm umbilical port in surgical glove endobag. In acutely inflamed cases, the gall-bladder was opened at the umbilical port site inside the endobag and decompressed before retrieval. In this group, wound infection of umbilical port occurred in 5.11% patients, port-site hernia in 3.66%, port-site bleeding in 1.33% while difficulty in retrieval of gall-bladder in acutely inflamed cases in 1.88% patients. In group-II, wound infection in epigastric port was found in 1.55% patients, port-site hernia in 0.11%, port-site bleeding in 4%, difficulty in retrieval of gall-bladder in 5.33% while leakage /perforation of gall-bladder in 4.11% patients. The serious complications like wound infection and port-site hernia are more frequently found in group-I patients as compared to group-II