Outcome of Laparoscopic Cholecystectomy in a District Level Hospital

Background: Laparoscopic cholecystectomy is a type of surgery that uses smaller incision than open cholecystectomy. LC has been performed as outpatient procedure for many years. Few studies have been conducted with primary focus on patient acceptance and preferences in terms of safety and satisfaction. We tried to explore its feasibility in otherwise healthy individuals undergoing laparoscopic cholecystectomy. The aim of the study of laparoscopic cholecystectomy is significantly affected by acute cholecystitis. Mechanical, biochemical, and bacteriological factors which are believed to participate in this inflammatory process are responsible for the different pathological processes observed in acute cholecystitis and in symptomatic cholelithiasis. Material & Methods: Data from 57 patients between the age group 20 to 70 years with cholelithiasis who underwent laparoscopic cholecystectomy in a private Hospital, Madaripur, Bangladesh from April 2018 to June 2020 as ambulatory surgery (hospital stay 23 Hours) with or without overnight stay were analyzed. Complications, admissions and readmissions, patient satisfaction and treatment expenditure were assessed. Results: There were 48 (84.2%) female and 9 (15.8%) male with a median age of 42 years. Only 2.4% patients required readmission while 9.2% patients had unplanned admission. 76.4% percent patients were highly satisfied with the procedure. Treatment cost was about 15% lower than routine inpatient operation. Conclusion: Laparoscopic cholecystectomy is safe and feasible. LC can be performed as an outpatient procedure with a low rate of complications and admissions/readmissions. Patient acceptance in terms of satisfaction is high.

Frequency of hepatitis B and hepatitis C in healthy blood donors of NWFP: a single center experience

To determine the frequency of hepatitis B and hepatitis C in asymptomatic healthy blood donors. Material and A prospective study was conducted in the department of Pathology, Rehman Medical Institute, Peshawar from April 2002 to March 2003. A total of 4000 healthy blood donors were selected. Blood samples were collected for screening of HBs Ag and anti HCV antibodies using IMX or Axsym, MEIA technology [Abbott, USA]. Even after strict selection of healthy donors 1.9% were found to be reactive for hepatitis B and 2.2% were found to be reactive for hepatitis C. The rate of incidence of hepatitis C was higher in blood group B negative [6.81%] while the rate of incidence of hepatitis B was higher in donors with blood group B positive [2.47%]. Screened blood bags received from other transfusion centers showed higher rates [4.27%] of hepatitis viral infections. These indicate that most of the patients suffering from hepatitis B and hepatitis C do not realize that they have got such deadly viruses in their body and can transmit it to non-infected healthy individuals via different parenteral routes including blood transfusion. The rate of infection of hepatitis B and C found in this study is low compared to other regional studies. One possible explanation could be the introduction of pre-donation filtration by questionnaire method which has been found to be an effective tool in addition to routine virological screening using high quality standard methods

Experience of peptic ulcer perforation over a decade in a teaching hospital of southern Bangladesh.

OBJECTIVE: To determine disease characteristics, check the treatment status and compare outcome with other series. DESIGN AND SETTING: A retrospective study in a single unit of the Department of Surgery of Khulna Medical College Hospital, south west Bangladesh. PATIENTS AND METHODS: After diagnosis by clinical and radiological examination, 491 patients were treated during the period July 1992 to November 2002. Two options of treatment were carried out: simple closure and peritoneal lavage in 364 cases, and 127 patients managed by non-surgical methods. Main outcome measures: mortality and morbidities. RESULTS: Male:female ratio was 445:46, average age 43 years. Mortality in the surgical group was 6.8% and in the non-surgical group 0.02%. CONCLUSION: Perforated peptic ulcer is prevalent even after the wide use of H2 receptor antagonists. Strict case selection for surgical and non-surgical treatment has reduced mortality. These results support the case for non-operative treatment and for conservative surgery.