A prospective evaluation of laparoscopic cholecystectomy in the treatment of chronic cholelithiasis: A five-year experience

Introduction. Laparoscopic cholecystectomy is a method of choice in the treatment of symptomatic cholecystolithiasis because of less postoperative pain, shorter hospitalization and lower cost of treatment. The study was aimed at analysing the outcome of laparoscopic cholecystectomy in patients surgically treated for chronic calculous cholecystitis (symptomatic cholelithiasis). Material and methods. The research was done in the period from December 2003 to December 2008. In the prospective study of 386 patients, we analyzed operative and postoperative complications, the reasons for conversion to open cholecystectomy, duration of hospitalization and mortality. Results. The average duration of laparoscopic cholecystectomy was 31.9?14.5 min: dissection of adhesions 3.2?0.7 min., elements of Calot?s triangle 9.8?3.2 min., gallbladder releasing from its bed 12.8?2.8 min., the abdominal cavity lavage and removal of gall?bladder from the abdomen 6.8?0.9 min. Some operative difficulties emerged in 22 (5.7%) patients - 4 (1%) during releasing of gallbladder adhesions from the surrounding structures, 9 (2.3%) during dissection of elements of the Calot?s triangle, 6 (1.5%) during gallbladder releasing from its bed, 3 (0.7%) during gallbladder removal from the abdomen. Some post-operative complications, single or associated, occurred in 36 (9.3%) patients: perforation of gallbladder 21 (5.4%), bleeding from gallbladder bed 18(4.6%)/, injury of extra hepatic bile ducts 1 (0.2%), 9 (2.3%) spillage of stones; 3 (0.7%) conversions were made. The average duration of preoperative and postoperative hospitalization was 1.1?0.3 and 1.4?0.5 days, respectively. The pathohistological examination revealed 2 (0.5%) adenocarcinoma of gallbladder. There were no lethal outcomes. Conclusion. Laparoscopic cholecystectomy is a safe procedure and rational choice in the treatment of biliary dyskinesia and symptomatic biliary calculosis with an acceptable rate of conversion.

Download Full-text

EVALUATION OF CLINICO-RADIOLOGICAL FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY

10.36106/ijar/2009947 ◽

2021 ◽

pp. 63-66

Author(s):

Wasif Mohammad Ali ◽

Nazia Nanen ◽

Atia Zaka Ur Rab ◽

Syed Amjad Ali Rizvi ◽

Mehtab Ahmad

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Open Cholecystectomy ◽

Previous History ◽

Safe Procedure ◽

Chi Square ◽

Preoperative Prediction ◽

Conversion To Open Cholecystectomy ◽

Chi Square Test ◽

A Prospective Study

Introduction: Laparoscopic cholecystectomy has become procedure of choice for treatment of symptomatic gallstone [1] disease . Even though it is a safe procedure occasionally it can be difcult and requires conversion to open cholecystectomy for various problems faced during surgery. Preoperative prediction of difcult laparoscopic cholecystectomy and likelihood of conversion to open cholecystectomy will avoid such complications and overall cost of treatment. Aim: To evaluate the clinico-radiological factors predicting difcult laparoscopic cholecystectomy Methods: This was a prospective study conducted from October 2018 to November 2020. Total of 101 patients meeting inclusion criteria undergoing laparoscopic cholecystectomy were included in the study. Various clinical, radiological and biochemical parameters and intraoperative difculties during surgery were recorded. The statistical analysis was done using chi-square test and ANOVA test. Results: The parameters such as sex, age, duration of disease, co-morbid disease, previous history of cholecystitis, palpable gall bladder, BMI, TLC, thickness of gall bladder, largest stone size and impacted stone are found statistically signicant in predicting difcult laparoscopic cholecystectomy and conversion to open cholecystectomy preoperatively. Conclusion: Difcult laparoscopic cholecystectomy may be predicted preoperatively even with a good clinical judgement whereas both clinical and radiological parameters provide a better preoperative prediction of difcult cholecystectomy so that the surgeon can prepared in advance for the complications.

Download Full-text

RESULTS OF EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH AN ACUTE CALCULUS CHOLECYSTITIS AND ISCHEMIC HEART DISEASE

Medical Science of Ukraine (MSU) ◽

10.32345/2664-4738.3-4.2017.03 ◽

2018 ◽

Vol 13 (3-4) ◽

pp. 15-21

Author(s):

V.G. Mishalov ◽

S.O. Kondratenko ◽

L.Yu. Markulan

Keyword(s):

Heart Disease ◽

Laparoscopic Cholecystectomy ◽

Ischemic Heart Disease ◽

Open Cholecystectomy ◽

Group Versus ◽

Ischemic Heart ◽

Acute Calculous Cholecystitis ◽

Delayed Laparoscopic Cholecystectomy ◽

Conversion To Open Cholecystectomy ◽

Calculous Cholecystitis

Relevance. Determination of the optimal time for laparoscopic cholecystectomy (LCE) in patients with acute calculous cholecystitis (ACC) and ischemic heart disease (IHD) is still an actual and unresolved issue. Objective: to evaluate the results early versus delayed LCE in patients with ACC and IHD. Materials and methods. The study involved 107 patients with ACC and IHD: 56 (47,7 %) women and 51 (52,3 %) men aged 55 to 82 years, an average 70,2±0,6 years. The group with early LCE (ELCE) included 48 patients with LCE – up to 72 hours from the beginning of ACC (on average 41,9±2,1 hours), the group with delayed LCE (DLCE) – 59 patients, who were LCE for more than 72 hours (in average 90,2±1,6 hours) from the beginning of ACC. Groups of patients were representative according to the functional classes of heart failure, angina pectoris, severity and the histological form of ACC. All patients had a Charlson comorbidity index from 0 to 2 points. The endpoint of the study were: the frequency of conversion to open cholecystectomy, cardiac events in the intra – and early postoperative periods, the incidence of complications according to the Clavien-Dindo classification. Data analysis was performed using IBM SPSS Statistics. Results. The duration of LCE in the DLCE group was 45,2±2,1 minutes, in the ELCE group it was 40,9±1,4 min (p=0,115). Conversion to open cholecystectomy was required in 8 (13,6 %) patients of the DLCE group versus one (2,1 %) in the ELCE group, p=0,033. During the operation, myocardial ischemia occurred in 17 (28,8 %) patients of the DLCE group versus 6 (12,5%) the ELCE group, p=0,041, and a systolic blood pressure decrement lower than 70 mm hg. art. – in 24 (40,7 %) against 8 (16,7 %), p=0,007; saturation reduction episodes – in 33 (55,9 %) against 17 (35,4 %), p=0,034, respectively. In the early postoperative period, an increasing of HF class according to NYHA was observed in 12 (20,3 %) patients of the DLCE group versus one (2,1 %) in the ELCE group, p=0.004; the number of patients with complications according to Clavien-Dindo classification – 40 (67,8 %) versus 23 (47,9 %), p=0,038; pneumonia occurred in 26 (44,1 %) against 6 (12,5 %), p=0,001; exudative pleurisy – in 28 (47,5 %) against 9 (18,8 %), p=0,002, respectively. There were no lethal cases in the period up to 7 days in both groups. Conclusion. ELCE is a priority method of treatment patients with an acute calculous cholecystitis (ACC) and ischemic heart disease (IHD) with a different functional class (according to NYHA). Compared with DLCE, it is associated with reliable reduce of conversion (2,1 %), against 8 (13,6 %), intra- and early postoperative complications of the cardiovascular system and complications according to Clavien-Dindo classification – 23 (47,9 %) patients against 40 (67,8 %).

Download Full-text

Complications of Two Port Laparoscopic Cholecystectomy-Studyof 50 Cases

TAJ Journal of Teachers Association ◽

10.3329/taj.v31i1.41572 ◽

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

Download Full-text

Laparoscopic cholecystectomy in elderly patients

Acta chirurgica iugoslavica ◽

10.2298/aci0902087s ◽

2009 ◽

Vol 56 (2) ◽

pp. 87-91

Author(s):

V. Stanisic ◽

M. Bakic ◽

M. Magdelinic ◽

H. Kolasinac ◽

M. Miladinovic

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Complications ◽

Elderly People ◽

Open Cholecystectomy ◽

Safe Procedure ◽

Old Patients ◽

Quick Recovery ◽

Symptomatic Cholelithiasis ◽

Associated Diseases ◽

Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy (LC ) is the method of choice of surgical treatment of gallbladder diseases. Operations in elderly people over 65 years because of chronic diseases, are often associated with high operative and postoperative morbidity and mortality. The aim of this study was to analyze the outcome of LC in the treatment of cholelithiasis in patients older than 65 years. For evaluation of LC effectiveness and security in old patients, we did this prospective analysis of 81 patients surgically treated because of symptomatic cholelithiasis . We had analyzed associated diseases, operative and postoperative complications, the reasons of conversion to open cholecystectomy. The research points to the small percentage of operative and postoperative complications, short hospital stay, less postoperative pain, quick recovery and savings in treatment. The age can not be contraindication for LC in older patients. In uncomplicated symptomatic cholelithiasis in elderly people, LC is a successful and safe procedure. Complicated symptomatic cholelithiasis, because of longer duration of operations is looking for a good assessment of general condition and associated diseases for LC.

Download Full-text

Laparoscopic Cholecystectomy- A Safe treatment option for Gangrenous Cholecystitis 48 and Empyema Gallbladder in experienced hands

Journal of Surgical Sciences ◽

10.3329/jss.v19i2.43981 ◽

2019 ◽

Vol 19 (2) ◽

pp. 48-51

Author(s):

Samiron Kumar Mondal ◽

Sharmistha Roy

Keyword(s):

Laparoscopic Cholecystectomy ◽

Open Cholecystectomy ◽

Operating Time ◽

Laparoscopic Procedure ◽

Safe Procedure ◽

Intracorporeal Suturing ◽

Gangrenous Cholecystitis ◽

Number Of Patients ◽

Conversion To Open Cholecystectomy ◽

Operative Recovery

Background: Laparoscopic cholecystectomy has become the gold standard of treatment for gall stone disease and in acute cholecystitis. But controversy persists regarding laparoscopic approach to gangrenous gallbladder and empyema gallbladder due to the risk of life threatening complications. We share our experience in a tertiary care multidisciplinary diabetic hospital where we encounter significant number of patients with empyema Gallbladder and gangrenous gallbladder because most of our patients are diabetic and hence immunocompromised. Purpose of this study was to evaluate the safety of laparoscopic procedure for the treatment of empyema of gallbladder and gangrenous gallbladder in an experienced hand. Methods & Materials: Between January 2013 and January 2015 we performed 1191 cases of laparoscopic cholecystectomy. Empyema gallbladder and gangrenous gallbladder were found per operatively in 345 and 53 cases respectively.All were managed by laparoscopic procedure except two cases, where conversion to open cholecystectomy was needed. Result: The mean operating time was 72 minutes(45-100 minutes) in empyema gallbladder. In gangrenous cholecystitismean operating time was 80 minutes(60-100 minutes). Total number of patients (including empyema gallbladder 345 and gangrenous cholecystitis 53) were 398. Among them 52 patients (13%) had excessive bleeding(>100ml) from calot’s triangle or gallbladder bed in liver. Spillage of stones occurred in 28 patients (7%). 1 patient had common bile duct injury (.25%). Gallbladder retrieval was difficult in 71 patients (18%). In the post operative period 21 patient (5%) developed minor port infection in the umbilical port. 9 patients (2%) developed chest infection, and 1 patient (.25%) developed MI. 356 patients (89%) were discharged within 72 hours of surgery. Conclusions: Innovative technique, appropriate instruments, knowledge about the possible risks and way to manage them, with expertise in intracorporeal suturing and knotting are an essential pre requisites to attempt these cases. Operating time is more but post operative recovery is prompt. Hospital stay is significantly less than open cholecystectomy. Laparoscopic cholecystectomy is a safe procedure in cases of Empyema and gangrenous gallbladder, provided the surgeon is experienced enough and has a low threshold to convert to open cholecystectomy at anypoint of time. Journal of Surgical Sciences (2015) Vol. 19 (2) : 48-51

Download Full-text

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

10.36106/ijsr/7502922 ◽

2019 ◽

Author(s):

Madan Goyal ◽

R K Goel

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Open Cholecystectomy ◽

Critical View Of Safety ◽

Recent Onset ◽

Conversion To Open Cholecystectomy ◽

Threatening Condition ◽

Life Threatening ◽

Fluid Collections ◽

A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

Download Full-text

Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

Kathmandu University Medical Journal ◽

10.3126/kumj.v7i1.1761 ◽

1970 ◽

Vol 7 (1) ◽

pp. 26-30 ◽

Cited By ~ 5

Author(s):

R Gabriel ◽

S Kumar ◽

A Shrestha

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Predictive Factors ◽

Open Cholecystectomy ◽

Abdominal Cavity ◽

Bladder Wall ◽

Patient Factors ◽

College Hospital ◽

Biliary Pain ◽

Conversion Rates

Background: Laparoscopic cholecystectomy has now replaced open cholecystectomy for the treatment of gallbladder diseases. However, certain cases still require conversion to open procedures. This study identifies and evaluates risk factors that may predict conversion from laparoscopic to an open procedure. Objectives: To identify and evaluate the predictive factors for conversion of laparoscopic to open cholecystectomy. Materials and methods: A total of 234 Laparoscopic cholecystectomies were attempted at the Kasturba Medical College Hospital, Manipal, from January 2003 to July 2005. Of these, 61 had to be converted to open cholecystectomy. A retro and prospective analysis of different parameters, including Patient factors, Intra-operative factors and Surgeon factors were performed. Results: Sixty one (26.1%) laparoscopic cholecystectomies required conversion. Factors contributing to conversion included male sex, age group of 31-40 years, over weight and history of biliary pain within last two to four months, ultrasonography findings of multiple calculi and gall bladder wall thickness of more than 3 mm. Intraoperative gall bladder perforation with spillage of its contents in abdominal cavity and dense adhesions with difficult anatomy resulted in higher conversion rates. Surgery performed by surgeons in learning phase of laparoscopic surgery was more prone to conversion. Conclusion: Patient factors, presentation, preoperative ultrasonography findings and surgeon's experience, all contribute to the possibility of conversion of laparoscopic cholecystectomy. Knowledge of these factors may help in preinformation to patient for psychological preparations for conversion and an experienced surgeon can plan to operate on these patients. Key words: Cholecystectomy, laparoscopy, conversion. doi: 10.3126/kumj.v7i1.1761 Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 26-30

Download Full-text

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

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i2.405 ◽

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.

Download Full-text

Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

Annals of Punjab Medical College ◽

10.29054/apmc/2021.1099 ◽

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.

Download Full-text

Laparoscopic cholecystectomy during COVID-19 pandemic- Retrospective analysis of tertiary care centre

Nepal Mediciti Medical Journal ◽

10.3126/nmmj.v2i2.41282 ◽

2021 ◽

Vol 2 (2) ◽

pp. 82-86

Author(s):

Uttam Laudari ◽

Rosi Pradhan ◽

Dibesh Shrestha ◽

Bibek Timilsina ◽

Suhail Sapkota ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Retrospective Analysis ◽

Infection Prevention ◽

Open Cholecystectomy ◽

Gallbladder Disease ◽

Tertiary Care ◽

Infection Prevention And Control ◽

Biliary Colic ◽

Tertiary Care Centre ◽

Duration Of Hospitalization

INTRODUCTION: Laparoscopic cholecystectomy is the most commonly performed general surgical procedure. During the COVID-19 pandemic, general recommendation worldwide is to postpone elective surgeries as far as possible to decrease the resource utilization and also aerosol-related transmission among hospital staff and patients. We conducted this study to see the burden of gallbladder disease, their management and outcomes of all patients who presented to our centre during first wave of COVID-19 pandemic. METHODS: We conducted a retrospective analysis of all patients who underwent laparoscopic cholecystectomy at the Hospital for Advanced Medicine and Surgery (HAMS) after the commencement of strict lockdown in the first wave of the COVID-19 pandemic. Ethical approval for the study was taken from Nepal Health Research Council. All the surgeries were performed as per HAMS interim policy for infection prevention and control during the COVID-19 pandemic. Data were extracted from the discharge sheet and outcomes in terms of duration of hospitalization, morbidity, mortality, and COVID -19 infection among patient and operating team staff after surgery were assessed. RESULTS: Out of 110 cases operated for gallbladder disease, 90 patients were included in the study with complete data. The most common presentations were dyspepsia (28) and biliary colic (22). Patients were managed with laparoscopic cholecystectomy (79), percutaneous cholecystostomy (4), laparoscopic subtotal cholecystectomy (5), open cholecystectomy (1). The median duration of hospitalization 22 hours. There was no COVID-19 transmission among staff and patients. CONCLUSIONS: Laparoscopic cholecystectomies are feasible during COVID-19 pandemic and safely performed following infection prevention guidelines. It can be still be performed in day case basis to decrease the bed occupancy and avoiding crowd in hospitals.

Download Full-text