Mini-Laparoscopic Cholecystectomy Versus Standard Laparoscopic Cholecystectomy: A Comparative study

INTRODUCTION Gallstones are the most common conditions encountered in surgical OPD. The prevalence rose with age, except in women of 40-49 years, so that at 60-69 years, 22.4% of women and 11.5% of men had gall stones or had undergone cholecystectomy. With the help of this study, best treatment option for cholecystectomy patient (whether to insert drain or not), was ensured in terms of post lap cholecystectomy collections of bile or blood, drain site pain. The study was provide knowledge whether drain insertion was benecial or harmful to patient. MATERIALS AND METHODS This comparative study was presented to the surgery OPD and emergency department with cholelithiasis within a period of 1 year from the approval of Research committee and Ethics Committee, Adesh institute of medical sciences and research, Bathinda. The primary outcome variable used to calculate sample size is amount of collection on post-operative day 3(Quantitative Variable) in both groups. Total 100 patients were present in this study. RESULT In this present study VAS median grade in patients with drain was G4 (48%), followed by G3(47%) then G2(5%). VAS median grade in without drain group was G2 (48%), followed by G3(31%) and G1(16%). CONCLUSION There is no signicant difference as far as post operative wound infection in laparoscopic Cholecystectomy with drain or without drain. Therefore in patients undergoing laparoscopic cholecystectomy keeping drain can be avoided as it does not provide any additional benet.

Download Full-text

Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0068 ◽

2017 ◽

Vol 99 (6) ◽

pp. 485-489 ◽

Cited By ~ 3

Author(s):

F Basak ◽

M Hasbahceci ◽

A Sisik ◽

A Acar ◽

Y Ozel ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Case Control Study ◽

Gallbladder Disease ◽

Case Control ◽

Control Group ◽

Study Group ◽

Pain Scores ◽

Standard Laparoscopic Cholecystectomy ◽

Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

Download Full-text