scholarly journals An Unusual Incarcerated Port Site Hernia due to retained partial gall bladder with stones - A case report.

KYAMC Journal ◽  
2013 ◽  
Vol 3 (2) ◽  
pp. 309-311
Author(s):  
Mohd. Farid Hossain ◽  
Md. Rakib Uddin ◽  
Raihanul Islam Emon ◽  
Md. Manhbur Rashid Sarkar

A 50 years old lady presented to the Emergency department with what appeared to be a strangulated infraumbilical hernia. She was explored and found to have an unexpected, unusual diagnosis -- incarcerated port site hernia with early features of strangulation. There was fundic part of gall bladder loaded with stones in the center of hernial contents. Gall bladder was surrounded by inflammed pad of omentum. The defect and the mass was approximately 6-8 cm below the umbilical port site incision scar of laparoscopic cholecystectomy, performed 13 years back. Excision of the inflammed hernial contents and Herniorraphy was performed. Patient recovered completely. Complications related to introduction of ports and incomplete removal of gall bladder may present in various ways and sometimes many years after the primary surgery. Methods of reducing the risk of such complications and pathogenesis of hernia in this case are discussed. KYAMC Journal Vol. 3, No.-2, January 2013, Page 309-311 DOI: http://dx.doi.org/10.3329/kyamcj.v3i2.15174

2020 ◽  
Vol 11 (2) ◽  
pp. 16-20
Author(s):  
Dr. Abdul Ghani Soomro

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.


2020 ◽  
pp. 1-2
Author(s):  
Zayd Ashok ◽  
Priyanka pant

Background and aim - Cholilithiasis is most common cause for cholecystectomy. These days laparoscopic cholecystectomy is the standard treatment for cholilithiasis. Extraction of gall bladder is an important cause for post operative pain after cholecystectomy. Laparoscopic cholecystectomy is still evolving, the number of ports are being reduced day by day. From standard four port to single incision and using natural orifices (NOTES). This study was done to determine whether the patients undergoing gall bladder retrieval via umbilical port was associated with more complications than epigastric port in a standard four port laparoscopic cholecystectomy. Method - 400 patients were selected for the study and were randomly allocated into 2 groups. Postoperatively, port-site pain score assessed at 2, 6, 12, and 24 hours by visual analog scale (VAS) score both for the epigastric and umbilical ports in all the patients and other variables are assesed accordingly and the collected data were analyzed by using SPSS version 22. Result - The postoperative pain and spillage was more in retrieval via epigastric port with only mild technical difficulty and relatively higher incidence of port site hernia from the retrieval port in retrieval via umbilical port.


2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  

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.


2021 ◽  
Vol 15 (12) ◽  
pp. 3399-3401
Author(s):  
Naeem Ahmed ◽  
Maryum Saleem Raha ◽  
Uzma Shamim Seth ◽  
Mohammad Taha Kamal ◽  
Anum Nawazish Al ◽  
...  

Background: The gallbladder is a hollow organ that sits just beneath the right lobe of the liver. Chief functioning of gallbladder is to store gall, also known as bile that is required for digestion of food. Removing gallbladder through small incision in the abdomen is called laparoscopic cholecystectomy. Among benefits of cholecystectomy are decreased need for postoperative analgesia, decreased postoperative pain and shortened hospital stay from 1 week to less than 24 hours. Objective: To compare the frequency of port site wound infection with and without endogloves techniques of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis. Design: It was a randomized controlled trial. Study Settings: This study was conducted at Department of General Surgery, Midland Doctors Medical Institute Tandali Muzaffarabad from July 2019 to July 2021 Material and Methods: A total of 260 cases who fulfilled inclusion criteria were enrolled in the study through wards of Department of General Surgery. Written informed consent was obtained from all the patients. Two groups were made by random division of patients. Conventional laparoscopic cholecystectomy was performed in patients of group I. Through umbilical port gall-bladder was retrieved in these patients, exactly spot on by a sterile surgical hand glove endobag. Vicryl “O” with J-shaped needle was used to close 10mm umbilical port (fascial defect) and 5mm ports were conventionally closed. In patients of group II, conventional laparoscopic cholecystectomy was performed and gall-bladder was retrieved as in patients of group I but without using surgical sterile hand glove endobag. Results: The mean age of the patients in study group was 48.09±15.402 years and in control group it was 47.51±16.48 years. Male to female ratio was 1.06:1. The post-op wound infection was found in 11 (4.23%) patients. Statistically significant difference was found in groups (P<0.05). Conclusion: The use of endoglove technique of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis is safe, cheap, simple and potentially reduces significant port site wound infection compared to without endogloves. Keywords: Laparoscopic Cholecystectomy, Endoglove, Gallbladder (GB).


2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Bogusław Koszman

AbstractGall-bladder duplication is a rare anatomical variation, which can affect safe performance of cholecystectomy and be a cause of persistent symptoms and a need for reoperation in case of accessory gall-bladder omission.A case of successfully performed elective laparoscopic cholecystectomy in a patient with duplicated gall-bladder accidentally intraoperatively disclosed is presented.The identified anomaly was classified according to the Harlaftis Classification of Multiple Gall-bladders. Attention was drawn to the uneffectivenes of ultrasound scanning in multiple gall-bladders preoperative detecting, and presence of other non-biliary anatomical variation in the same individual as well.


Author(s):  
Omesh K. Meena ◽  
Monish Raj

Blunt trauma abdomen leading to gallbladder perforation is a rare event usually recognized on evaluation and treatment of other visceral injuries during laparotomy. The gallbladder is relatively a well-protected organ. Isolated gallbladder perforation is extremely rare. The clinical presentation is variable, early diagnosis and treatment is of extreme importance to reduce morbidity and mortality associated with gallbladder perforation. We report a case of a patient who sustained isolated gallbladder injury following blunt trauma abdomen to emergency department in Safdarjung Hospital, New Delhi.


2018 ◽  
Vol 14 (3) ◽  
pp. 247
Author(s):  
GangaRam Verma ◽  
Gautham Krishnamurthy ◽  
VijayChetan Jha

2020 ◽  
Vol 27 (08) ◽  
pp. 1717-1721
Author(s):  
Ehsanullah Malik ◽  
Sania Bhatti ◽  
Muharram Ali Abbasi ◽  
Yasmeen Bhatti ◽  
Abdul Sattar Abro ◽  
...  

Laparoscopic cholecystectomy is a gold standard procedure for the management of patients with cholelithiasis with fewer complications but still port site hernia is one of the severe complications if not treated properly may lead adverse result. This usually results from improper closure or infection of the musculoaponeurotic layers of the abdominal wall. The frequency of port site hernia is variable in literature and its association with infection and other co-morbidities is less explored. Objectives: To determine the frequency of port-site hernia after laparoscopic cholecystectomy at a tertiary care hospital Larkana and its association with infection and co-morbidities. Study Design: Descriptive Case Series study. Setting: Department of Surgery, Chandka Medical College Teaching Hospital, Larkana. Period: December 2018 to December 2019. Material & Methods: One hundred forty-eight patients undergoing elective laparoscopic cholecystectomies, who fulfilled the inclusion criteria and gave informed consent were selected for this study. All the patients were followed for 6 months. Data was recorded for age, gender, BMI, smoking and diabetes mellitus status. Infection and port site hernia were observed during the follow-up period. The SPSS version 21 was used for data analysis. Results: The majority of the patients 79 (53.4%) were above the age of 35 years. The mean age of the patients was 40.14 ±11.40 years. Females were younger than males. Among them 19 (12.8%) were males compared to 129 (87.2%) females. Mean BMI (kg/m2) of male patients were 25.98±3.53 and female patients were 24.80±3.04. The mean duration of surgery was 63.72 (+18.20) minutes, mostly accomplished is within 80mins (54.1%).  Out of 148 patients in 5 (3.4%) patients port site hernia was observed. In all these patients wound to get infected and surgery was for a prolonged period. A significant association has been found between port site hernia, operative time and port site infection. However, no significant association has been found between port site hernia and gender, age, smoking and Diabetes (P>0.05). Conclusion: The frequency of port site hernia is low but could be disastrous if the bowel gets obstructed. Using good technique and reducing operative time are effective measures in reducing the port site infection and the port site hernia.


Sign in / Sign up

Export Citation Format

Share Document