ABSTRACT
To compare the complications of laparoscopic versus open appendectomy. Retrospective study. This study was conducted at Dow University Hospital from June 2012 to June 2014. Data was analyzed by reviewing patient records, patients bills records and patient discharge sheet. Each data was double checked and thoroughly supervised by author himself to assure quality and validation of the data collected. The information reviewed of patients with diagnosis of acute appendicitis included, age, sex, time taken for bowel function restoration, use of analgesia, postoperative stay and its clinical evaluation and confirmed by USG of abdomen requiring operation and total charges. Patients included who were operated in surgical unit I. Patients who were identified with associated gynecological disease, to be at high risk for general anaesthesia, had a past history of lower abdominal surgeries, appendicular abscess were excluded. Data was analyzed through SPSS software. 73 patients who underwent appendicectomy. Out of which 24 [32.87%] patients operated laparoscopically and 49 [67.12%] patients by open method. The mean age for open appendectomy was 26.53 +/- 12.3 years whereas, for laparoscopic appendectomy it was 29.9 +/- 13.3 years. Intraoperative findings were normal appendix 4[16.66%] in OA group and 2[4.08%] in LA group, Acute appendicitis 12[50%] in OA group and 31[63.26%] in LA group, Gangrenous appendicitis 3[12.5%] in OA group and [14.28%] in LA group, Appendiceal abscess 4[16.66%] in OA group and 5[10.20%] in LA group, Peritonitis 1[4.16%] in OA group and 3[6.12%] in LA group. Post operative complications were observed in both groups. Wound infection 5[20.83%] in OA group and 2[4.08%] in LA group, Intra-abdominal abscess 1[4.16%] in OA group and 1[2.04%] in LA group, Bowel obstruction 3[12.5%] in OA group and 2[4.08%] in LA group, Respiratory infection 2[8.33%] in OA group and 1[2.04%] in LA group. This retrospective comparative assessment indicates that the patient chart reduces the incidence of complications in LA was wound infection, intestinal damage, intra-abdominal abscesses, intestinal obstruction and respiratory infections
ABSTRACT
To find out frequency of bile duct injuries during cholecystectomy procedures either open or laparoscopic.Prospective observational study. This study was conducted at Surgical department, Liaquat University Hospital Jamshoro and Dow International Hospital Karachi, from July 2012 to December 2013. This study consisted of hundred patients. Patients were divided in two groups. Group A for open cholecystectomy [OC] comprising of 50 patients who underwent elective open cholecystectomy. Group B for Laparoscopic cholecystectomy [LC] comprising of 50 patients who underwent elective Laparoscopic cholecystectomy. Inclusion criteria were all patients diagnosed case of gallstones on the basis of ultrasound abdomen, any age and both gender. Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant ladies due to risk of foetal loss, carcinoma of gall bladder, stone in CBD and obstructive jaundice. Out of 100 cases of gallstone were operated for either laparoscopic / open cholecystectmy. In open cholecystectomy group 20[40%] were male and 30[60%] female. Ratio male: female ratio of 1:1.5. In laparoscopic cholecystectomy group 11[22%] were male and 39[78%] female with male: female ratio of 1:3.5. There was wide variation of age ranging from a minimum of 10 year to 70 year in both group. The mean age was 41.28+12.30 years for OC group and 38.44+13.50 years for LC group [p 0.02]. Common bile duct injury were occurred 2[4%] patients in laparoscopic cholecystectomy group while 3[6%] patients observed in open cholecystectomy group. We conclude that found bile duct injury 2[4%] patients in laparoscopic cholecystectomy group while 3[6%] patients observed in open cholecystectomy group