The Study of Laparoscopic Cholecystectomy in Acute Cholecystitis, Complication and Management: Analysis of 150 Cases in the Ibn Sina Medical College, Bangladesh

2021 ◽  
Vol 20 (2) ◽  
pp. 318-322
Author(s):  
Md Jahangir Hossain Bhuiyan ◽  
Mahbub Hasan ◽  
Omar Faruk
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Single Port ◽  
Open Cholecystectomy ◽  
Medical Science ◽  
Biliary Tract Disease ◽  
Ibn Sina ◽  
Medical College ◽  
Single Port Surgery ◽  
Tract Disease

Background: Laparoscopic Cholecystectomy has now become a better option instead of the Open Cholecystectomy for treatment of Cholelithiasis that it has been a gold standard for the Cholelithiasis condition throughout the Globe. Last century was the most fruitful era for the treatment of the biliary tract disease as it has already proved the progress from the open to laparoscopic surgery with a single port surgery. Methods: The purpose of our study is to grading of the Laparoscopic Cholecystectomy in Acute Cholecystits and has been studying the outcome of problematic and challenging Laparoscopic Cholecystectomy cases, its’ complication (s) and management to decide when to converting Laparoscopic Cholecystectomy to Open Cholecystectomy. The study analyzes the conversion rate of Laparoscopic Cholecystectomy in the Ibn Sina Medical College, Kallyanpur, Dhaka, Bangladesh. This is a retrospective study of 150 patients (Male - 75% and Female - 25%) which was conducted during the period from January 2015 to January 2017. Results: Out of the 150 cases 140 (93%) had been successfully operated by Laparoscopic Cholecystectomy. And, only 10 (7%) cases (out of a total of 150) got converted from the Laparoscopic to Open Cholecystectomy and they belonged to Grade - E with severely contracted gallbladder, morbid adhesion, short cystic duct and bile duct injury. Conclusions: The Laparoscopic Cholecystectomy has familiar as a unique procedure of choice for the management of symptomatic gall bladder. Laparoscopic Cholecystectomy intra operatively for grade A to E where Grade A is very easy level to perform Gall Bladder Surgery to Grade E where conversion is 115% due to bad. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.318-322

Concurrent Biliary Disease Increases the Risk for Conversion and Bile Duct Injury in Laparoscopic Cholecystectomy: A Retrospective Analysis at a County Teaching Hospital

2017 ◽  
Vol 83 (10) ◽  
pp. 1024-1028 ◽  
Author(s):  
Lara H. Spence ◽  
Samuel Schwartz ◽  
Amy H. Kaji ◽  
David Plurad ◽  
Dennis Kim
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Biliary Tract ◽  
Bile Duct Injury ◽  
Odds Ratio ◽  
Open Cholecystectomy ◽  
Biliary Tract Disease ◽  
Endoscopic Retrograde ◽  
Conversion To Open Cholecystectomy ◽  
Tract Disease

Biliary tract disease remains a common indication for operative intervention. The incidence of concurrent biliary tract disease (>2 biliary tract disease processes) is unknown and the impact of more than one biliary tract diagnosis on outcomes remains to be defined. The objective of this study was to determine the effect of concurrent biliary tract disease on conversion rate and outcomes after laparoscopic cholecystectomy. A 5-year retrospective analysis of all patients who underwent a laparoscopic cholecystectomy was performed comparing those with a single biliary diagnosis to patients with concurrent biliary tract disease. Variables analyzed were conversion to open cholecystectomy, incidence of bile duct injury, use of endoscopic retrograde cholangiopancreatography and/or intraoperative cholangiogram, length of surgery, and duration of hospitalization. The incidence of concurrent biliary tract disease was 9 per cent and a conversion to open cholecystectomy was performed in 16 per cent of patients. After adjusting for confounding factors, concurrent biliary tract disease was predictive of conversion (odds ratio 1.6, 95% confidence interval 1.1–2.3, P = 0.03) and bile duct injury (odds ratio 2.5, 95% confidence interval 0.8–5, P = 0.01). Concurrent biliary tract disease patients were more likely to undergo intraoperative cholangiogram or endoscopic retrograde cholangiopancreatography, as well as longer operation and length of stay.

EVALUATION OF CLINICO-RADIOLOGICAL FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY

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.

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 Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

1970 ◽  
Vol 7 (1) ◽  
pp. 26-30 ◽  
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     

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 Efficacy of an herbal product (Habb-E-Munish) in treatment of ED Using IIEF-5 scores and it’s effect on liver and renal functions

2019 ◽  
Vol 19 (1) ◽  
pp. 176-179
Author(s):  
Md Anwar Hussain ◽  
Mohd Nurul Alam ◽  
Nafisa Ahmed ◽  
Hasan Said ◽  
Syeda Fahmida Afrin ◽  
...  
Keyword(s):  
Medical Science ◽  
Herbal Product ◽  
Developed Countries ◽  
Functional Domain ◽  
Ibn Sina ◽  
Medical College ◽  
Liver And Kidney ◽  
Term Basis ◽  
Male Subjects ◽  
Positive Effect

Background and Rationale: Incidence of erectile dysfunction is rising in both developing and developed countries including Bangladesh. Even in this 21st century people attracted to the herbal and/alternative medicine. The present study was aimed to evaluate the effect of Haab-e-Munish in the treatment using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Material and Methods: A total 33 married male subjects participated in this study. The study was approved by the Research and Ethics Committee of the Ibn Sina Medical College & Hospital. Informed written consent was obtained from each participant. Data were expressed as mean±SD and were managed by SPSS for Windows Version 17. P<0.05 was considered significant. Results: Mean (SD) age of the participants was 36.8±7.7. Basic data like pulse, blood pressure, serum creatinine, urea and alanine aminotransferase (ALT) were unchanged compared to the baseline. IIEF Score of all five functional domain demonstrated significant improvement from the baseline. Conclusion: Herbal preparation Haab-e-Munish has positive effect in improving erectile dysfunctions and is safe for liver and kidney function on short term basis. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.176-179

scholarly journals Determination of predictive factors for difficult laparoscopic cholecystectomy

2021 ◽  
Vol 8 (2) ◽  
pp. 481
Author(s):  
Sameer Bhattarai ◽  
Ishory Bhusal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Predictive Factors ◽  
Open Cholecystectomy ◽  
Bladder Wall ◽  
College Teaching ◽  
Wall Thickening ◽  
Conversion To Open Cholecystectomy ◽  
Male Sex

Background: Cholelithiasis is the most common biliary pathology, with a prevalence of 10 to 15%. It is symptomatic in approximately 1 to 2% of patients. In about 5 to 10% of laparoscopic cholecystectomy, conversion to open cholecystectomy may be needed for safe removal of gallbladder. Laparoscopic cholecystectomy (LC) may be rendered difficult by various problems encountered during surgery. The objective of this study was to predict difficulty of LC before surgery using the clinical and ultrasonographic criteria.Methods: The present study comprised of 45 cases admitted to National Medical College Teaching Hospital (NMCTH), Birgunj (Nepal) for a period of 12 months from 1st August 2013 to 30th September 2014. The cases confirmed by Ultrasonography were evaluated with following risk factors: age >50 years, male sex, BMI 25.1 to 27.5 and >27.5, previous surgery, prior hospitalization, palpable gall bladder, gall bladder wall thickening, impacted stone, pericholecystic collection and presence of adhesions. Each risk factor was given a score. The total score up to 5 predicted easy, 6 to 10 difficult and more than 10 very difficult.Results: The highest age incidence of Cholelithiasis was in the 2nd to 4th decade and was more common in females. Ultrasonography detected gallbladder stones in all patients, wall thickening in 15 and pericholecystic collection in 8. BMI >27.5 presence of adhesions, male sex and pericholecystic collection were significant predictors of difficult laparoscopic cholecystectomy.Conclusions: Numerous clinical, radiological and pre-operative features make LC sometimes difficult. Early determination of these predictive factors decreases the difficulty that we will be facing with LC.

Unusual fistula demonstrating the need for an early cholecystectomy

2020 ◽  
Vol 13 (9) ◽  
pp. e235795
Author(s):  
Gregory Harrison ◽  
Roland Fernandes
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Early Cholecystectomy ◽  
Calot’S Triangle ◽  
Initial Episode ◽  
Laparoscopic Assisted ◽  
Definitive Management ◽  
Active Disease

A 79-year-old man developed a spontaneous cholecystocutaneous fistula 12 months after an initial episode of acute cholecystitis. A laparoscopic cholecystectomy procedure was twice abandoned due to extensive adhesions and active disease, limiting safe dissection of Calot's triangle. Abdominal collections formed and a spontaneous cholecystocutaneous fistula developed. Imaging revealed an 11 cm calculus and erosion of the fundus of the gall bladder through the sheath. Definitive management was achieved with a laparoscopic assisted open cholecystectomy.

scholarly journals Bile Duct Injuries Following Laparoscopic Cholecystectomy

2018 ◽  
Vol 15 (1) ◽  
pp. 14-19
Author(s):  
Mohammad Ibrahim Khalil ◽  
Haridas Saha ◽  
Azmal Kader Chowdhury ◽  
Imarat Hossain ◽  
AZM Mostaque Hossain
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Open Cholecystectomy ◽  
Standard Procedure ◽  
Gall Stone ◽  
Common Bile Duct Injury ◽  
Medical College ◽  
Bile Duct Injuries ◽  
Case Files

Background: Laparoscopic cholecystectomy (LC) is the gold standard procedure for the gall stone diseases.Objective: This study aimed to assess the outcome of laparoscopic cholecystectomy (LC) by determining the frequency of complications especially of bile duct injuries.Methodology: This retrospective study was conducted in the Department of surgery at Dhaka Medical College and Hospital, Dhaka, Bangladesh. The case files of all patients undergoing laparoscopic cholecystectomy (LC) from the year of 2013 to 2015 were retrospectively analyzed. The data were collected according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose resections had to be converted from laparoscopic to open surgery.Results: During the three years a total number of 336 patients were underwent LC for chronic cholecystitis (CC) of which 22(6.5%) developed complications. Among those who developed complications, two patients had major bile duct injuries (0.4%); other 43(12.8%) patients had planned laparoscopic operations converted to open cholecystectomy intra-operatively. None of the patients in this study died as a result of LC.Conclusion: The two patients who had severe common bile duct injury in this study had major anatomical anomalies that were only recognized during surgery.Journal of Science Foundation 2017;15(1):14-19

scholarly journals GALLBLADDER CARCINOMA;

2011 ◽  
Vol 18 (01) ◽  
Author(s):  
AHMAD HASSAN KHAN ◽  
SAIFULLAH GORAYA ◽  
HAROON-UR- RASHID
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gallbladder Carcinoma ◽  
Open Cholecystectomy ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Surgical Department ◽  
Carcinoma Gallbladder ◽  
Average Operating ◽  
Average Operating Time

Objective: Chronic Cholecystitis is one of the commonest diseases presenting in surgical department and is subjected to cholecystectomy each time. A suspicious gall bladder on ultrasound initiates further investigations to rule out carcinoma of gall bladder yet some times a benign looking gall bladder on ultrasound turns out to be carcinoma of gall bladder on histopathology. Design: Descriptive study. Place & Duration of study: District Head Quarters Hospital, Sargodha, from September 2007 to March 2009. Patients & Methods: 200 patients who underwent both open and Laparoscopic cholecystectomy for cholelithiasis were subjected to this study. All relevant data was documented on a standardized data form. Patients were between the ages of 28-74. Patients already diagnosed as Gallbladder Carcinoma, empyema gall bladder, mucocele and gall bladder polyp were excluded from the study. Gall bladders removed after each surgery ware sent to laboratory for histopathological evaluation. Results: A total of 200 cases were studied (161 females, 39 males; M: F ratio 1:4). The mean age was 45 years (range 28-74 years). The most common presenting complaint was pain right hypochondrium with nausea and vomiting (85%).The average operating time was 50 minutes in case of open cholecystectomy and 1 hour in laparoscopic cholecystectomy. Complications included biliary leak in 2 patients (1%), Wound Infection in 3 patients (1.5%) and death in one case (0.5%). The overall rate of complications was 3%. There were a total of 5 patients of laparoscopic cholecystectomy who required extension of the incision, for Carcinoma Gallbladder. Conclusions: Carcinoma of gall bladder is a very aggressive malignancy and usually presents at a very advance stage as its symptoms mostly are marked by symptoms of cholecystitis. Detection of gall bladder carcinoma is very difficult in early stages on ultrasound. Any findings in ultrasound suggesting malignancy should be confirmed on further investigations like CT scan .Carcinoma of Gall bladder is not very common in cases of cholecystectomy for chronic Cholecystitis but once found should be dealt with extreme precision following established operating protocols. 

Sign in / Sign up

Export Citation Format

Share Document