scholarly journals Perioperative complications of laparoscopic cholecystectomy: a cross-sectional observational study

2020 ◽  
Vol 7 (5) ◽  
pp. 1490
Author(s):  
Sanjeev Agarwal ◽  
Arpit D. Joshi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Perioperative Complications ◽  
Gallbladder Disease ◽  
Bile Leakage ◽  
Safe Procedure ◽  
Trocar Site ◽  
Cross Sectional ◽  
Intraoperative Complication ◽  
Mortality And Morbidity ◽  
Almost All

Background: Laparoscopic cholecystectomy (LC) has now become the gold standard in treatment of benign gall bladder disease. The intraoperative and immediate postoperative complication cannot be disregarded and remain of concern. The study aims to evaluate the perioperative complications of LC in patients undergoing the surgery.Methods: A total of 100 patients were included in this prospective analytical study from a June 2017 to September 2019. They were adequately evaluated and underwent LC in General surgery department of Geetanjali Medical College and Hospital, Udaipur. The relevant clinical details of all the patients were recorded and analysed.Results: Among the patients who underwent LC, majority were females. In case of 86 patients, LC was done due to chronic calculous cholecystitis. The conversion rate from laparoscopic to open was 6%. The most frequent intraoperative complication was trocar site bleeding and liver bed injury, 7%, followed by bile leakage from gallbladder 6%, bleeding from calots triangle in 4% and spilled gallstones in 2% cases. There was no case of injury to common bile duct, bowel injury or major vascular injury. Amongst the post-operative complications, wound infection was in 1% case. No perioperative mortality was present. The overall rate of complication was 18%.Conclusions: LC is a safe and effective procedure in almost all patients presenting with symptomatic gallbladder disease and remains one of the most frequently performed laparoscopic operations. It has a low rate of mortality and morbidity making this operation a safe procedure with favourable results.

scholarly journals Complications of Laparoscopic Cholecystectomy

2019 ◽  
Vol 17 (2) ◽  
pp. 73-79
Author(s):  
ABM Khurshid Alam ◽  
Mashrur Akbar Khan ◽  
Rashed Uz Zaman ◽  
Md Ali Akbar ◽  
Md Abul Bashar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallbladder Disease ◽  
Gallstone Disease ◽  
Gall Stone ◽  
Bile Leakage ◽  
Port Site ◽  
Trocar Site ◽  
College Hospital ◽  
Port Site Hernia ◽  
Complications Of Laparoscopic Cholecystectomy

Background: laparoscopic cholecystectomy is now regarded as the "Gold Standard" treatment option for benign gallbladder disease. But it is not free of procedure related complications. Objective: To review the complications of laparoscopic cholecystectomy for gall stone disease. Materials & Method: A prospective observational study was carried out over a period of 9 years beginning from 1st of July 2003 till 30th of June 2012 in Comilla Medical College Hospital and several private hospitals of Comilla. A total of 946 patients who underwent laparoscopic cholecystectomy for symptomatic and asymptomatic gallstone disease as confirmed by ultrasound scan were included. Patient having cirrhosis of liver, ischaemic heart disease, suspected carcinoma of gall bladder were excluded from the study. The outcome including the complications was analyzed. Result: Out of 946 patients 632 (66.80%) were females and 314 (33.19%) were males. Most (92.3%) of them were between 21-50 years of age. The commonest immediate complication was bleeding from liver bed (9.40%), from vascular injury in Callot's triangle (5.17%) and from the trocar site (4%). There was spillage of gallstones in 104(10.99%) cases. Bowel injury was seen in only one (0.10%) case. Bile leakage was observed in 4(.42%) cases that also include CBD injury .in 3 cases. The procedure was converted to open surgery in 11(1.17%) cases. Port site infection was seen in 43 (4.54%) cases. Late complications include port site hernia in 6 (0.63%) cases, port site keloid in 1 (.1%) case and CBD stricture in 5 (0.54%) cases. Mortality was unavoidable in in 2(0.21%) cases. Conclusion: With increasing experience laparoscopic cholecystectomy can be a safe and effective procedure for most patients with cholelithiasis. Proper training and sound knowledge of possible complications can yield favorable results and lesser complications. Journal of Surgical Sciences (2013) Vol. 17 (2) :73-79

scholarly journals SURGICAL AUDIT - LAPAROSCOPIC CHOLECYSTECTOMY IN A FREE CAMP AT PRIVATE SECTOR HOSPITAL

2020 ◽  
Vol 11 (2) ◽  
pp. 16-20
Author(s):  
Dr. Abdul Ghani Soomro
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
Port Site ◽  
Bladder Injury ◽  
Safe Procedure ◽  
Trocar Site ◽  
Port Site Hernia ◽  
Surgical Audit

BACKGROUND & OBJECTIVE: Laparoscopic Cholecystectomy is usual method for the treatment of gall bladder stone disease and is practiced all over the world due to many benefits like fasten the recovery time. Furthermore, it reduced the post-operative pain and period of hospital stay. To conduct Surgical Audit and evaluate safety of Laparoscopic cholecystectomy. METHODOLGY: This prospective study was conducted in a private hospital at Hyderabad during free camps of Laparoscopic Cholecystectomy. Four camps were arranged in 2016 - 2019. Total number of 190 patients  underwent Laparoscopic Cholecystectomy during the study period. The patient's age falls between 12–65 years. A detailed history, relevant investigation and Cardiac fitness were evaluated. All patients underwent four ports Lap-Chole. Data was collected assessed and audit was performed and safety was evaluated. RESULTS: Total 190 patients operated females 88.45% and males 11.55%. 115 (60.50%)were in  the range of 30-35 years followed by 55 (28.95%)patients in the range of 40-50 years.8 (4.20%) patients were converted to open cholecystectomy, 4 due to bleeding from liver bed, 3 patients due to difficult dissection in calots triangle and 1 due to Empyema of gall bladder.10 patients (5.50%) had Trocar site bleeding, 10 patients (5.50%) had gall bladder injury, in 4 cases had spillage of stones and 72 patients (38.50%) developed umbilical port site infection 1 patient develop port site hernia. No mortality was recorded in this study. CONCLUSION: Our Surgical Audit proves that Laparoscopic Cholecystectomy is a safe procedure on the basis of only 4.2% intra operative and 5.5% postoperative complications and gaining wide spread popularity among our population due to less pain, less hospital stay. We recommend other private hospitals to extent such services to our poor population with symptomatic cholelithiasis.

scholarly journals Factors Affecting the Perception and Practice of Iranian Nomadic and Semi-Nomadic Pastoralists in Regard to Biosecurity Practices in Sheep and Goat Farms: A Cross-Sectional and Prospective Study

Ruminants ◽  
2022 ◽  
Vol 2 (1) ◽  
pp. 54-73
Author(s):  
Zeinab Hatami ◽  
Richard A. Laven ◽  
Saeid Jafari-Gh. ◽  
Mahdi Moazez-Lesko ◽  
Pegah Soleimani ◽  
...  
Keyword(s):  
Prevention Measures ◽  
Extension Programs ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Factors Affecting ◽  
Nomadic Pastoralists ◽  
Almost All ◽  
Biosecurity Practices ◽  
Umbilical Cords ◽  
Annual Mortality

Preventing the spread of diseases between and within farms (biosecurity) is essential for minimizing animal mortality and morbidity, as well as for reducing the risk of spread of zoonotic diseases. These effects are even greater in countries such as Iran, which have to deal with multiple ongoing epidemics of infectious disease. However, there is currently no published information about biosecurity practices on sheep and goat farms in Iran in published research. The aim of this study was to collect such information and to identify some of the factors affecting biosecurity practices. Data were gathered using a checklist and in-depth interviews with 99 nomadic and semi-nomadic pastoralists. Regression analysis was used to identify the relationships between the collected variables and the biosecurity scores. The results showed that neither within- nor between-farm disease prevention measures were appropriately applied on most farms (median total score of total biosecurity was 37.3/90; Q1 = 29.0 and Q3 = 44.7). Almost all the farmers reported slaughtering animals on farms and nobody properly disposed of the bodies of the dead animals. Additionally, the majority of the participants did not disinfect the umbilical cords of newborns. Of the collected variables, the annual mortality rate was associated with most within-farm biosecurity practices. The increase in annual mortality rates was associated with the regular cleaning of troughs (p = 0.03), preventing feed and water from being contaminated by urine and feces (p = 0.02), providing a clean and dry place for animals to rest (p = 0.05) and disinfecting the navel cord (p = 0.03). The results of this survey suggest that there is a clear need for extension programs to enhance Iranian and sheep and goat farmers’ perceptions and practices regarding biosecurity measures.

Feasibility and safety in difficult laparoscopic cholecystectomies; a single surgeon experience.

2020 ◽  
Vol 11 (4) ◽  
pp. 12-16
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Cross Sectional Study ◽  
City Hospital ◽  
Class Iii ◽  
Cross Sectional ◽  
Surgeon Experience ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

Background: laparoscopic cholecystectomy is commonly used for the treatment of gallstones. Objective: To determine the feasibility and safety of difficult laparoscopic cholecystectomies. Methodology: This cross sectional study was based on retrospective collection of data from patient records, including 323 patients with difficult laparoscopic cholecystectomies was conducted in Department of Surgery, Sharif Medical City Hospital, and Rasheed Hospital, Lahore from June 2010 to December 2019. Difficult cholecystectomy was defined on intraoperative findings based on Nassar intraoperative scoring system. Feasibility was defined as successful accomplishment of procedure without complication and safety was defined as having no intraoperative or postoperative complications. Results: There were 75 (23.21%) male and mean age was 48±8 years. Class I difficulty was observed in 185 (57.3%) patients, class II difficulty in 83 (25.7%) patients, class III difficulty in 44 (13.6%) patients and class IV difficulty in 11 (3.4%) patients. Mean duration of surgery and mean hospital stay were 98.87±11.76 minutes and 1.91±1 days, respectively. Conversion to open cholecystectomy was done in 10 (3.1%). The procedure was feasible in 313 (96.9%) patients. Overall complications were seen in 19 (5.9%) patients. The complications included Common Bile Duct injury in 1 (0.31%) patient, intraoperative bleeding in 1 (0.3%) patients, bile leakage in 2 (0.62%) patients, postoperative jaundice in 3 (0.93%) patients, superficial infections in 10 (3.1%) patients and deep infections in 2 (0.62%) patients. Safety of laparoscopic surgery was seen in 304 (94.1%) patients. Conclusion: Laparoscopic cholecystectomy in difficult situations was found to be feasible and safe in majority of patients. However, it was associated with a longer operative time.

scholarly journals DOES MALE GENDER INCREASE THE RISK OF LAPAROSCOPIC CHOLECYSTECTOMY?

2019 ◽  
Vol 32 (2) ◽  
Author(s):  
Júlio Cezar Uili COELHO ◽  
Giuliano Ohde DALLEDONE ◽  
Wagner SCHIEL ◽  
Jacqueline de Pauli BERBARDIN ◽  
Christiano M. P. CLAUS ◽  
...  
Keyword(s):  
Risk Factor ◽  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Perioperative Complications ◽  
Male Gender ◽  
Female Group ◽  
Intraoperative Complication ◽  
Study Protocols ◽  
Conversion To Open Cholecystectomy

ABSTRACT Background: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. Aim: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. Method: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. Results: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p<0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p<0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). Conclusion: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.

Role of Ultrasound Screening for Gallbladder Disease in Pretransplant Patients

2008 ◽  
Vol 74 (9) ◽  
pp. 832-833
Author(s):  
Madhavi Meka ◽  
Santosh Potdar ◽  
Peter Benotti ◽  
J. Edward Hartle ◽  
Christopher Senkowski
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallbladder Disease ◽  
Graft Loss ◽  
Day Surgery ◽  
Control Group ◽  
Study Group ◽  
Gallstone Pancreatitis ◽  
Safe Procedure ◽  
Ultrasound Screening ◽  
Clinical Value

There is no uniform data regarding prophylactic cholecystectomy in patients undergoing renal transplantation with gallbladder disease. Data analyses suggest that posttransplant patients on cyclosporine have a higher incidence of gallbladder calcifications compared with nonimmunosuppressed patients. Laparoscopic cholecystectomy is a relatively safe procedure in modern-day surgery. Taking these facts into consideration, we attempted to compare risks and complications associated with gallbladder disease and eventual cholecystectomy in pretransplant versus post-transplant patients. Between June 1999 and December 2005, 210 renal transplants were performed at our institution. One hundred four patients who had transplants before April 2003 were not screened for gallbladder disease and nine of these patients developed gallbladder disease. These patients form our control group. One hundred six patients who had transplants after April 2003 had pretransplant screening for gallbladder disease and 11 patients were identified with gallbladder disease. These patients form our study group. Nine patients who developed gallbladder disease after renal transplant underwent laparoscopic cholecystectomy with three resulting morbidities (33%), two graft losses (22%), and one mortality (11%). There was one mortality (11%) in this group. One patient in the study group died of acute gallstone pancreatitis. Of the 11 patients who were found to have gallbladder disease on screening, nine patients underwent laparoscopic cholecystectomy with one morbidity and no mortality or graft loss. Given the relative rarity of the critical events in this study (morbidity, mortality, and graft loss), the definitive statistical value of prescreening for gallbladder disease cannot be established. However, our results are suggestive of clinical value and thus we tentatively recommend ultrasound screening for gallbladder disease for all pretransplant patients and laparoscopic cholecystectomy for those identified to have gallbladder disease.

scholarly journals Clinical profile, etiology, management and outcome of serum sodium disturbances in children admitted in PICU

2017 ◽  
Vol 5 (6) ◽  
pp. 2546
Author(s):  
Balaji Jayakumar ◽  
Ekambaranath Sambasivam
Keyword(s):  
Intensive Care ◽  
Venous Blood ◽  
Pediatric Intensive Care ◽  
Urine Osmolality ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Glucose Levels ◽  
Sick Children ◽  
Almost All

Background: Sodium disorders are common in children who need intensive care, they occur in variety of conditions, may remain unrecognized if not suspected and monitored and result in morbidity and mortality irrespective of primary problem. The aim of the study is to know etiology, management and outcome of sodium disturbances in sick children admitted to pediatric intensive care unit to Institute of Social Pediatrics Stanley Medical College.Methods: This is a hospital based cross sectional study. Two hundred and twenty-seven children in the age group of 1month to 12 years admitted in PICU over the period of 8 months were included in the study. Venous blood sampling is obtained from each patient enrolled in the study and is sent for estimation of electrolytes, blood urea, glucose levels. Serum osmolality (calculated), urine osmolality, urine spot sodium were done in selected patients.Results: Among the 227 children studied, 85 children had sodium disturbances that included both hyponatremia (80 children) and hypernatremia (5 children) The most common cause of hyponatremia is CNS disorder 25 patients (31.25%) followed by poisoning 17.Conclusions: Hyponatremia occurs frequently and should be looked for in all sick children. It is of hypotonic- euvolemic type in almost all the acute infections except diarrhea and should be managed accordingly. They contribute significantly to the mortality and morbidity. 

scholarly journals Is it Safe to Perform Laparoscopic Cholecystectomy for Acute Calculus Cholecystitis within 7 Days Following Symptom Onset?

2018 ◽  
Vol 56 (214) ◽  
pp. 945-948 ◽  
Author(s):  
Rajesh Poudel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Symptom Onset ◽  
Conversion Rate ◽  
Bivariate Analysis ◽  
Safe Procedure ◽  
Cross Sectional ◽  
Early Laparoscopic Cholecystectomy ◽  
Significant Difference ◽  
Duration Of Surgery

Introduction: Although operation within “golden 72 hours” from the onset of symptoms has been suggested for acute calculus cholecystitis, such early surgery is hardly possible in clinical practice because of variable timing of presentation. The aim of this study is to compare the outcomes of patients undergoing laparoscopic cholecystectomy within 72 hours of symptom onset with patients undergoing surgery after 72 hours up to 7 days of symptom onset for acute calculus cholecystitis.Methods: This is a descriptive cross-sectional study carried out from November 2016 to July 2018. Patients with acute calculus cholecystitis were divided in two groups according to the onset of symptoms. Main outcomes measured were conversion rate, duration of surgery, length of hospital stay and intraoperative complications.Results: Total 64 patients were evaluated. Among which 18 (28.1%) underwent surgery within 72 hours of onset of symptom. Around 46 (71.9%) underwent surgery after 72 hours of symptom onset. On bivariate analysis there were no significant differences in mean duration of surgery, hospital stay and conversion to open surgery between two groups. Conclusions: Early laparoscopic cholecystectomy is a safe procedure when done within 7 days of symptom onset. There were no significant difference in conversion rate, operative time, hospital stay, morbidity and mortality.

scholarly journals Reinterventions following laparoscopic cholecystectomy and bile duct exploration. A review of prospective data from 5740 patients

2021 ◽  
Author(s):  
Hwei Jene Ng ◽  
Ahmad H. M. Nassar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Perioperative Complications ◽  
Bile Leakage ◽  
Common Bile Duct Exploration ◽  
Index Admission ◽  
Biliary Surgery ◽  
Open Conversion ◽  
High Workload ◽  
Low Incidence

Abstract Background Complications following laparoscopic cholecystectomy (LC) and common bile duct exploration (CBDE) for the management of gallstones or choledocholithiasis impact negatively on patients’ quality of life and may lead to reinterventions. This study aims to evaluate the causes and types of reintervention following index admission LC with or without CBDE. Methods A prospectively maintained database of LC and CBDE performed by a single surgeon was analysed. Preoperative factors, difficulty grading and perioperative complications requiring reintervention and readmissions were examined. Results Reinterventions were required in 112 of 5740 patients (2.0%), 89 (1.6%) being subsequent to complications. The reintervention cohort had a median age of 64 years, were more likely to be females (p < 0.0023) and to be emergency admissions (67.9%, p < 0.00001) with obstructive jaundice (35.7%, p < 0.00001). 46.4% of the reintervention cohort had a LC operative difficulty grade IV or V and 65.2% underwent a CBDE. Open conversion was predictive of the potential for reintervention (p < 0.00001). The most common single cause of reintervention was retained stones (0.5%) requiring ERCP followed by bile leakage (0.3%) requiring percutaneous drainage, ERCP and relaparoscopy. Relaparoscopy was necessary in 17 patients and open surgery in 13, 6 of whom not resulting from complications. There were 5 deaths. Conclusion This large series had a low incidence of reinterventions resulting from complications in spite of a high workload of index admission surgery for biliary emergencies and bile duct stones. Surgical or endoscopic reinterventions following LC alone occurred in only 0.8%. The most common form of reintervention was ERCP for retained CBD stones. This important outcome parameter of laparoscopic biliary surgery can be optimised through early diagnosis and timely reintervention for complications.

scholarly journals Complications of Two Port Laparoscopic Cholecystectomy-Studyof 50 Cases

2019 ◽  
Vol 31 (1) ◽  
pp. 29-37
Author(s):  
Nasir Uddin Mahmud ◽  
Ghyas Uddin ◽  
Md Anwarul Haque ◽  
ANM Mozammel Haque ◽  
AKM Golam Kibria
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Bile Leakage ◽  
Safe Procedure ◽  
Minimal Scarring ◽  
Conversion To Open Cholecystectomy ◽  
Port Infection ◽  
Good Cosmesis

Background: For the management of Gallstone disease, laparoscopic cholecystectomy has been the the gold standard and is preferred over open cholecystectomy. As patients’ demand has increased for improved postoperative quality of life and cosmesis, surgeons have continued to decrease the number of ports for laparoscopic cholecystectomy. To meet these expectations we adopted two-port techniques at Comilla, Bangladesh. For the last three years we have selected 50 patients where two-port laparoscopic cholecystectomy was trialled. The procedure were successfully performed in 47(94%) & conversion were required in 3(6%) with some accepted complications like epigastric port infection & herniation, post cholecystectomy syndrome, reactionary haemorrhage, bile leakage & biloma, significant epigastric port pain postoperatively & stricture of CBD. The present two port technique not only overcoming specimen extraction difficulties but also contributes to good cosmesis. Objectives: To see the outcome of two port laparoscopic cholecystectomy. Methods: Consecutive 50 patients were admitted in surgery ward of Central medical college, Comilla with gallstone disease over a 3 years period. Diagnosis is confirmed by ultrasound with the assessment of operative feasibility. Data collection sheet was maintained by Microsoft Excel. Data were analyzed manually. Results: In this study 50 patients were included. Among them 34 (68%) were females and 16 (32%) were males (ratio = 2.1:1). Mean age was 35.7 years (range 20–55years).All patient were undergone two port laparoscopic cholecystectomy & successfully accomplished in 47 (94%),conversion were required in 3 (6%) patients. Most common (62%) sonological findings were cholelithiasis with normal size & shape of gall bladder. Mean operative time was 50 minutes. Among the per operative difficulties bleeding were 14%, perforation of gall bladder 10%, spillage of gallstones 6%, epigastric forceps manipulation difficulties 4%,conversion to open cholecystectomy 6%. Most of the patients(80%) admitted in hospital for 2-3 days. 4 (8%) patient had epigastric port infection & 1 (2%) patient developed this site herniation, 3 (6%) patient had post cholecystectomy syndrome,1 (2%) patient had reactionary haemorrhage, 1 (2%) bile leakage & biloma,4(8%) patient had significant epigastric port pain postoperatively, 1 (2%) patient developed delayed stricture of CBD. In all other patients wound healed nicely with minimal scarring, with very less postoperative pain, with no problem so far in 3 years follow up. Most patients (90%) returned to work within 2 weeks. Conclusion: Two-port laparoscopic cholecystectomy is a safe procedure & cosmetically rewarding. TAJ 2018; 31(1): 29-37

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