scholarly journals Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Abdul Razaque Shaikh ◽  
Aaijaz Ahmed Shaikh ◽  
Mujib Rehman Abbasi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Three Dimensional ◽  
Port Site ◽  
Two Dimensional ◽  
Short Term ◽  
Term Outcome ◽  
Conversion To Open Cholecystectomy ◽  
Group A ◽  
Group B

Objective: To compare the short-term outcomes of three dimensional (3D) versus two dimensional (2D) laparoscopic procedures used for cholecystectomy. Methods: This study was conducted at minimally invasive surgery center of Liaquat University of Medical Health and Sciences (LUMHS) Jamshoro Pakistan, between 15th May 2017 to 16th December 2017 after taking informed consent. All patients were diagnosed cases of cholelithiasis without any complications. Patients having risk factors for inability to get access to gall bladder via laparoscope and in whom the chances of conversion to open cholecystectomy were greater were not included as part of study. One group of patients underwent cholecystectomy under 3D laparoscopy while other group underwent 2D laparoscopy. Surgeons included in the study were all well-trained. The short-term outcome noted were intraoperative and postoperative complications, conversion to open, operative time, mortality and hospital stay. Visual strain and headache for the surgeon in three D laparoscopic cholecystectomy. Results: A total of one hundred forty patients were included in the study. Group-A consists of sixty two females and eleven males whereas Group-B comprised of fifty eight females and fifteen males. Eight percent of patients in Group-A whereas in Group-B two percent had gallbladder rupture. Fifteen percent of patients in Group-A whereas 5.4% from Group-B had bleeding from liver bed. One patient from Group-A had CBD (Common Bile Duct) injury. Post-operatively two (2.73%) patients from Group-A had port site bleeding. Six (8.21%) patients had port site infection in Group-A. Conclusion: Three dimensional was found to have low incidence of intra-operative and post-operative complications compared to 2D laparoscopic cholecystectomy. doi: https://doi.org/10.12669/pjms.37.1.3721 How to cite this:Shaikh AR, Shaikh AA, Abbasi M. Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy. Pak J Med Sci. 2021;37(1):162-166. doi: https://doi.org/10.12669/pjms.37.1.3721 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

2021 ◽  
Vol 15 (1) ◽  
pp. 91-94
Author(s):  
Muhammad Nasir ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Early Laparoscopic Cholecystectomy ◽  
Female Patients ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Conversion To Open Cholecystectomy ◽  
Group A ◽  
Male Patients ◽  
Group B

Background: Laparoscopic Cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill define. Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe Laparoscopic Cholecystectomy. Objective: To compare the early and delayed Laparoscopic Cholecystectomy in the acute phase in terms of frequency of conversion to open cholecystectomy. Study Design: Randomized clinical trial. Settings: Department of Surgery, Divisional Headquarter Hospital, Faisalabad. Punjab Medical College, Faisalabad Pakistan. Duration: Study was carried out over a period of six months from June 2018 to May 2019. Methodology: A total of 152 cases (76 cases in each group) were included in this study. All patients were randomly allocated to either group i.e., group -A early Laparoscopic Cholecystectomy and group-B delayed Laparoscopic Cholecystectomy. Results: Mean age was 39.09 + 8.8 and 37.05+ 8.5 years in group- A and B, respectively. In group-A, male patients were 48 (63.2%) and female patients were 28 (36.8%). Similarly, in group-B, male patients were 41 (53.9%) and female patients were 35 (46.1%). Conversion to open cholecystectomy was required in 6 patients (7.9%) of group-A and 16 patients (21.0%) of group – B. Significant difference between two groups was observed (P= 0.021). Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible in terms of less frequency of conversion to open cholecystectomy.

scholarly journals Safety and feasibility of three port procedure in laparoscopic cholecystectomy

2019 ◽  
Vol 6 (6) ◽  
pp. 1975
Author(s):  
Vipin Gupta ◽  
Shailendra Pal Singh ◽  
Somendra Pal Singh ◽  
Anil Kumar Keshari ◽  
Anil Kumar Erry ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Standard Technique ◽  
Post Operative Pain ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic cholecystectomy is widely accepted gold standard technique for management of cholelithiasis and has undergone many refinements including decrease in size and number of ports. Many researchers have claimed that three-port laparoscopic cholecystectomy is safe and feasible method for management of cholelithiasis but still it is not performed widely by the surgeons. Objective of our study was to assess the safety and feasibility of three-port laparoscopic cholecystectomy by comparing the various defined parameters with the standard four-port laparoscopic cholecystectomy.Methods: The study included 100 patients and was divided equally in 2 groups. Patients in Group A underwent laparoscopic cholecystectomy by three-port technique and in Group B were operated by four-port technique. Patients in both the groups were compared in terms of operative time, intra-operative complications, post-operative pain, post-operative complications and cosmesis outcome.Results: The mean operative time was similar in both groups. Intra-op and post-op complications were also similar. 3 patients in Group A needed fourth port and 1 patient in both group required conversion to open cholecystectomy. Mean pain score and requirement of parentral analgesia was found to be lower in Group A. Duration of hospital was similar in both the groups. Patients in group A had slightly better cosmetic outcome.Conclusions: Three-port laparoscopic cholecystectomy is a minimally invasive, safe and feasible technique and is not difficult to master than other advanced techniques. In experienced hands, laparoscopy cholecystectomy can be initially started with three-ports and can be converted to four-port if rarely necessary.

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 253 ◽  
Author(s):  
Pramod Singh ◽  
Sumit Kumar Gupta ◽  
Mukesh Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
City Hospital ◽  
Site Infection ◽  
First Choice ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.

DOES EARLY LAPAROSCOPIC CHOLECYSTECTOMY AFTER ERCP OFFERS SIGNIFICANT BENEFIT IN SURGICAL OUTCOME? A COMPARATIVE STUDY BETWEEN EARLY AND LATE GROUPS

2021 ◽  
pp. 59-61
Author(s):  
Anshul Mathur ◽  
Ketan Patel ◽  
Jitendra Kumar Mangtani ◽  
K.K. Dangayach
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Endoscopic Retrograde ◽  
Endoscopic Retrograde Cholangiopancreaticography ◽  
Early Laparoscopic Cholecystectomy ◽  
Conversion Rates ◽  
Group A ◽  
Group B

Introduction:- Endoscopic retrograde cholangiopancreaticography (ERCP) prior to Laparoscopic Cholecystectomy(LC) is most commonly practiced strategy worldwide for management of co-existing cholelithiasis with choledocholithiasis. The time interval between Endoscopic Retrograde Cholangiopancreaticography (ERCP) and Laparoscopic cholecystectomy (LC) is questionable and varies from 1 day to 6 weeks in different studies. Aims and objectives:- To compare two groups of patients managed with laparoscopic cholecystectomy (after ERCP), EARLY(24 to 72 hours), and LATE(> 6weeks) in terms of mean operative time in minutes, intraoperative difculties, conversion rates to open cholecystectomy, conversion rates to open cholecystectomy, drain insertion required or not, postoperative complications, and duration of hospital stay. Materials and methods:- A prospective randomized comparative study was conducted on 70 patients who presented with concomitant cholelithiasis with choledocholithiasis over a period of January 2019 to June 2020 at the Department of General Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. After ERCP and stone retrieval patients were randomised into 2 groups using sealed envelope method. Group A underwent early laparoscopic cholecystectomy (24 to 72hours) and Group B underwent late laparoscopic cholecystectomy (after 6 weeks). Data collected, statistical analysis done, results and observations concluded. Result:- We found that mean operative time, intraoperative difculties, post operative complications and mean hospital stay in days were signicantly higher in Group B as compared to Group A. Though the conversion rates to open procedure and requirement of drain insertion were comparatively higher in Group B but were found to be statistically non signicant. Conclusion:- We hereby conclude that early laparoscopic cholecystectomy (24 to 72 hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP) is better as compared to late laparoscopic cholecystectomy (>6 weeks) after ERCP in patients of cholelithiasis with coexisting choledocholithiasis. So, we recommend performing early Laparoscopic Cholecystectomy (24-72hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP)

Short Term Outcome of Urethroplasty for Distal Hypospadias with Interrupted Suture Compared to continuous Suture

2013 ◽  
Vol 2 (1) ◽  
pp. 26-30
Author(s):  
MMR Shibli ◽  
S Hoque ◽  
AM Shahinoor ◽  
MAB Akan ◽  
S Zabeen
Keyword(s):  
Continuous Suture ◽  
Urethrocutaneous Fistula ◽  
Short Term ◽  
Term Outcome ◽  
Meatal Stenosis ◽  
Interrupted Suture ◽  
Short Term Outcome ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Background: Hypospadias is one of the most common congenital anomalies, occurring approximately 1in 200 to 1in 300 live birth. Urethrocutaneous fistula (U-C fistula), and meatal stenosis are the most common complication of hypospadias surgery. To reduce these complications there are different surgical procedures. Snodgrass technique is now the popular technique for its low complication rate and better cosmetic outcome. Objective: To explore the short term outcome of interrupted suture compared to continuos suture in snodgrass technique urethroplasty for distal penile hypospadias. Method: It was a randomized control trial study carried out in the department of Paediatric surgery, BSMMU during the period of June 2008 to September 2009. 32 patients with distal penile hypospadias were selected according to set inclusion and exclusion criteria. Subjects who included in the study were randomly distributed in two groups. In group A odd number of patients and in group B even number of patients were included for randomization. Group A (interrupted suture) was treated as interventional group and Group B (continuous suture) as control group. Penile stent was removed on 8th and 10th POD after snodgrass technique of urethroplasty in coronal and subcoronal hypospadias respectively and observed for 4 weeks for two common complications- Urethrocutaneous fistula (U-C fistula), and meatal stenosis. Unpaired t test, Fisher’s exact test were used to see the level of significance. Result: In group A out of 16 subjects; 2 subjects (12.5%) develop Urethrocutaneous fistula and 1 subject (6.3%) had developed meatal stenosis. In group B out of 16 subjects 6 subjects (37.5%) had developed Urethrocutaneous fistula and 3 subjects (18.8%) developed meatal stenosis. Conclusion: Urethrocutaneous fistula (U-C fistula), and meatal stenosis are the most common complication of hypospadias repair and the occurrence of these two complications are less in interrupted suture than that of continuous suture in Snodgrass technique urethroplasty for distal hypospadias. DOI: http://dx.doi.org/10.3329/jpsb.v2i1.15160 Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 26-30

scholarly journals Comparison of Morphologic Parameters of Temporomandibular Joint for Asymptomatic Subjects Using the Two-Dimensional and Three-Dimensional Measuring Methods

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yuanli Zhang ◽  
Xianchao Xu ◽  
Zhan Liu
Keyword(s):  
Temporomandibular Joint ◽  
Three Dimensional ◽  
Measuring Method ◽  
3D Models ◽  
Joint Space ◽  
Two Dimensional ◽  
Group A ◽  
Group B ◽  
Asymptomatic Subjects ◽  
Method Group

The differences of temporomandibular joint (TMJ) morphologic parameters by using two-dimensional (2D) and three-dimensional (3D) measuring methods were compared. Ten asymptomatic subjects (26.75 ± 4.89 years) were randomly recruited. The 3D models of the maxilla, mandible, and teeth were reconstructed according to cone-beam computed tomography (CBCT) image data. The morphologic parameters of TMJs were measured by the 2D CBCT measuring method (group A) and the 3D reconstruction model measuring method (group B), respectively. The morphologic parameters in each group were assessed by paired samplest-test, and the statistical significance was achieved whenp<0.05. The horizontal condylar angle (HCA), sagittal ramus angle (SRA), medial joint space (MJS), lateral joint space (LJS), superior joint space (SJS), and anterior joint space (AJS) in group A were significantly smaller than those in group B (p<0.05). The HCA on the left side was significantly smaller than that on the right side in group A (p<0.05). However, all the morphologic parameters in group B were not significantly different between left and right sides. In conclusion, there were significant differences for the morphologic parameters of TMJ measured on 2D CBCT and 3D models. 3D measuring method should be used for the detection of TMJ morphology in clinical practice.

scholarly journals COMPARISON OF SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH PORT SITE INFILTRATION OF LOCAL ANAESTHESIA IN LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 71 (2) ◽  
pp. 625-28
Author(s):  
Kaukab Majeed ◽  
Nazish Shaukat ◽  
Muhammad Ali Muazzam ◽  
Usman Khalid ◽  
Junaid Zafar ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Local Anaesthesia ◽  
Transversus Abdominis Plane Block ◽  
Port Site ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of ultrasound guided subcostaltransversus abdominis plane block and port site infiltration of local anaesthesia in patients undergoing laparoscopic cholecystectomy. Study Design: Comparative cross sectional study. Place and Duration of Study: Anesthesiology department, Pak Emirates Military Hospital, Rawalpindi, from Jan to Jun 2019. Methodology: A sample size of 62 patients calculated by World Health Organization calculator were randomized in a doubleblind study to undergo Sub costal transversus abdominis plane block or port site infiltration by non-probability, consecutive sampling into two equal groups. Group A received sub costal transversus abdominis plane block and group B local anaesthetic. Postoperative pain perception was measured using visual analogue scale. Results: The mean age of patients in group A was 33.39 ± 8.91 years and in group B was 33.77 ± 8.45 years. Out of 62 patients 38 (61.29%) were males and 24 (38.71%) were females. Mean pain score in group A (ultrasound guided sub costal transversus abdominis plane block) was 1.61 ± 0.91 while in group B (port site infiltration of local anaesthetic) was 3.61 ± 1.05 (p-value 0.0001). Conclusion: The mean pain score was less following use of ultrasound guided sub costal transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy as compared to port site infiltration of local anaesthesia.

scholarly journals Evaluation of difficulties in laparoscopic cholecystectomy

2017 ◽  
Vol 70 (9-10) ◽  
pp. 271-276
Author(s):  
Katarina Sarcev ◽  
Dimitrije Damjanov ◽  
Dijana Kosijer ◽  
Dragomir Damjanov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Conversion To Open Surgery ◽  
Preoperative Prediction ◽  
Conversion To Open Cholecystectomy ◽  
Group B

Introduction. For decades, laparoscopic cholecystectomy has been the gold standard in surgical treatment of patients with cholelithiasis all over the world. The main advantage of this approach is that it is a minimally invasive procedure for patients. Although this method is a routine in our country, there are certain cases where the presumed outcome of minimally invasive procedure is not achieved, and the surgery is converted to open surgery, or a subsequent laparoscopic surgery is performed, in order to deal with the complications. The aim of this study was to establish if it was possible to create a model for preoperative prediction of difficult laparoscopic cholecystectomies. Material and Methods. Two groups of patients were analyzed. Group A included patients with cholelithiasis who were studied in order to determine parameters associated with difficult laparoscopic cholecystectomies. Out of 16 analyzed parameters, 8 showed significant correlation with difficult laparoscopic cholecystectomies. Based on these parameters, a prediction model was established, consisting of five groups: I - easy (score 1), II - laparoscopic cholecystectomy with mild difficulties (score 2), III - laparoscopic cholecystectomy with major difficulties (score 3), IV - difficult (score 4), V - conversion to open surgery is expected (score 5). This model was preoperatively applied in patients with cholelithiasis included in group B. Results. The overall predictability of the model was 82%. The greatest prediction accuracy was achieved in groups II and III (98.3% and 100%, respectively). Conversion to open cholecystectomy was predicted in 76% of patients. Conclusion. Based on certain preoperative parameters it is possible to establish a model to predict a difficult laparoscopic cholecystectomy.

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