Post Operative Evaluation of Patients of Laparoscopy Cholecystectomy with and without Drain with the Help of Ultrasonography

Introduction: Most common complaints after laparoscopiccholecystectomy are abdominal pain, shoulder tip pain, andnausea, vomiting in the post-operative period. These havebeen attributed to high pressure pneumoperitoneum usingcarbon dioxide gas causing irritation of the diaphragm andother abdominal viscera. Thus, a drainage tube is insertedto decrease the intra-abdominal pressure to mitigate thesesymptoms. However, the role of routine drainage afterlaparoscopic cholecystectomy is still controversial. Severalstudies including some meta-analysis performed to assessthe role of drains in reducing complications in laparoscopiccholecystectomy could not definitively establish the same.The surgical community is divided on this issue due to thelack of evidence on usefulness of drain. Therefore, we planneda controlled randomized comparative study to assess the valueof drain in uncomplicated laparoscopic cholecystectomy.Material and methods: The study was conducted indepartment of General surgery Maharishi MarkendeshwarMedical college and Hospital, Kumarhatti, Solan, HimachalPradesh, India from July 2018 to June 2019. During a periodof one year, 50 patients (group A) were randomized to havea drain placed, with No. 14 Ryles tube, kept in sub hepaticspace after laproscopic surgery, whereas the other 50 patients(group B) did not have any drain in the subhepatic space.These patients were evaluated regarding any differences inmorbidity, postoperative pain, wound infection and hospitalstay between the two groups.Result and Conclusions: The present study was unableto substantiate the utility of subhepatic drain following theelective laproscopic cholecystectomy procedure.

Efficacy of Levosulpride in minimizing Post-operative Nausea and Vomiting after Laparoscopic Cholecystectomy

Introduction: Gallstone disease is a common problemin our country. Approximately, 80% of the gallstones areasymptomatic. The risk factors predisposing to gallstoneformation has been female sex, obesity, pregnancy, rapidweight loss, gallbladder stasis, and increasing age. Currentstudy aimed to evaluate the efficacy of levosulpiride inminimizing PONV in our patients.Material and Methods: The present study was conducted overa period of one year in the Department of Surgery from January2018 to December2018. One hundred patients fulfilling theeligibility criteria for elective laparoscopic cholecystectomywere enrolled in the study and were randomly placed into 2groups of fifty each.Result: Injection of 25 mg levosulpiride in the preoperative phase in patients undergoing elective laparoscopiccholecystectomy surgeries under general anesthesiasignificantly (P<0.001) reduces the incidence of nausea &vomiting in post-operative phase.Conclusion: levosulpride improved the quality of patient carein immediate post-operative phase and decreased the durationof hospital stay.