A STUDY ON INCIDENCE AND FACTORS ASSOCIATED WITH PORT SITE INFECTIONS POST LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 58-61
Author(s):  
A. Mohamed Arsath ◽  
Swapnil Sen ◽  
Ishita Laha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
Analysis Data ◽  
Port Site ◽  
Tertiary Care Centre ◽  
Iatrogenic Perforation ◽  
Culture And Sensitivity ◽  
One Year

Today, laparoscopic cholecystectomy is the gold standard for symptomatic gall stones. A port site infection (PSI) is dened as an infection of the skin and subcutaneous tissue at the site of ports created during laparoscopic cholecystectomy which discharges purulent material spontaneously or is opened to drain the same by the surgeon. Increased number of performed cholecystectomies, increased number of port site infections, although rare, it has signicant inuence in overall outcomes of lap cholecystectomy and its nal results like delay in return to work, increase in cost and bad cosmetic results. AIM:To nd out the incidence of Port site infections after laparoscopic cholecystectomy by clinical assessment and conrmed by swab test after culture and sensitivity. MATERIALS AND METHODS: Hospital based prospective observational study was done on patients undergoing laparoscopic surgeries during a period of one year in a tertiary care centre of Eastern India. Patients were examined for infections and if suspected swabs were sent for culture and sensitivity and treated accordingly. For statistical analysis data were analyzed by SPSS software. RESULTS: In our study, 69 patients were females and 31 were males who underwent Laparoscopic cholecystectomy and the mean age of patients was 40 years. The PSI was seen most commonly at epigastric port i.e. 4 among 6 patients, hence the port used for gall bladder retrieval and PSI was statistically signicant. We found that the most common organism was Staphylococcus aureus and all are the cases were supercial site infections. CONCLUSION:We can prevent port site infections by using endo bag for all cases which prevents the spillage of bile during surgery, by reducing the intra-operative time and by preventing iatrogenic perforation of the gall bladder during the surgery.

scholarly journals OUTCOMES OF LAPAROSCOPIC CHOLECYSTECTOMY IN DIFFERENT GRADES OF GALL BLADDER INFLAMMATION A TERTIARY CARE CENTRE EXPERIENCE

2021 ◽  
Vol 71 (4) ◽  
pp. 1252-55
Author(s):  
Amir Ali ◽  
Mukarram Hussain Syed ◽  
Taimoor Ashraf Khan ◽  
Farheen Aslam ◽  
Gufran Ahmad ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Acute Inflammation ◽  
Prospective Observational Study ◽  
Standard Treatment ◽  
Tertiary Care ◽  
Military Hospital ◽  
Tertiary Care Centre ◽  
Elective Procedure ◽  
Acute And Chronic Inflammation

Objective: To find the outcomes of laparoscopic cholecystectomy in gall bladders with all grades peri-operative inflammation. Study Design: Prospective observational study. Place and Duration of Study: Combined Military Hospital, Rawalpindi, from Nov 2018 to Aug 2019. Methodology: All patients with symptomatic gall bladder disease who underwent laparoscopic cholecystectomy (emergency/elective procedure) and American Anesthesiology Society (ASA) Score 1 or 2 were included in the study. Results: A total of 330 patients with a mean ± SD age of 48.01 ± 14.13 years underwent laparoscopic cholecystectomy. Out of 330 patients, 129 (39.1%) had acute inflammation of gall bladder while 201 (69.9%) cases were operated electively. The rate of conversion and complications were somehow lesser in both categories as the overall conversion rate was 15 (4.5%). Conclusion: Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gall stones. Moreover, it is safe option in acute and chronic inflammation of Gall bladder if performed by a experienced laparoscopic surgeon.

scholarly journals POSTOPERATIVE PORT-SITE PAIN AFTER GALL BLADDER RETRIEVAL FROM EPIGASTRIC VS UMBILICAL PORT IN LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 9 (09) ◽  
pp. 333-337
Author(s):  
Neel Ketu ◽  
Santosh Kumar ◽  
Prem Prakash
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Tertiary Care ◽  
Port Site ◽  
Adult Patients ◽  
P Value ◽  
Care Hospital ◽  
Duration Of Surgery ◽  
Elective Laparoscopic Cholecystectomy ◽  
Site Pain

Objective: To determine whether gall bladder (GB) retrieval from umbilical port is associated with more pain at port site as compared to GB retrieval from epigastric port in adult patients undergoing four port elective laparoscopic cholecystectomy at a tertiary care hospital. Methods: Adult patients, who were undergoing elective laparoscopic cholecystectomy during a six-month period in 2010 at our institute, were randomized to either group A (n = 60, GB retrieval through epigastric port) or group B (n = 60, GB retrieval through umbilical port). VAS for pain was assessed by a registered nurse at 1, 6, 12, 24 and 36 h after surgery. Results: The VAS for pain at umbilical port was less than epigastric port at 1, 6, 12, 24 and 36 h after surgery (5.9 ±1.1 vs. 4.1± 1.5, 4.6± 0.94 vs. 3.5± 1.05, 3.9± 0.85 vs. 2.4± 0.79, 3.05± 0.87 vs. 2.15± 0.87, respectively) and the difference was statistically significant (p-value < 0.001). Multiple linear regression was done for port site pain at 24 h and the VAS at umblical port was less than epigastric port with VAS difference of 0.9 after adjusting for age, sex, duration of surgery and additional analgesia use (r 2 =0.253, p-value < 0.001). Conclusion: Gall bladder retrieval from umbilical port is associated with lower port site pain than GB retrieval from epigastric port in patients undergoing elective laparoscopic cholecystectomy. We recommend umbilical port for gall bladder retrieval.

scholarly journals Study of cholecystectomy specimens over a period of one year in tertiary care centre

2017 ◽  
Vol 5 (3) ◽  
pp. 916
Author(s):  
I. Vijaya Bharathi ◽  
P. Urmila Devi ◽  
A. Bhagya Lakshmi
Keyword(s):  
Bladder Cancer ◽  
Gall Bladder ◽  
Bladder Carcinoma ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Gall Bladder Cancer ◽  
Tertiary Care Centre ◽  
Gall Bladder Carcinoma ◽  
Hematoxylin And Eosin ◽  
One Year

Background: Gall bladder is among the most common surgically resected organs with various neoplastic and non-neoplastic lesions. Chronic chocystitis is the most commonly encountered lesion in India and worldwide and 78-90% are associated with calculi. Gall bladder cancer constitutes 0.5% to 1.09% including both suspected and incidental diagnosis. The objective of present study was to evaluate the various lesions of Gall bladder and the importance of grossing and histopathological examination of every cholecystectomy specimen in order to diagnose the incidental gall bladder cancer (IGBC).Methods: A Retrospective study of cholecystectomy specimens for a period of one year, May 2015 to June 2016 was carried out. 252 Cholecystectomy specimens were received and all of them subjected for histopathological examination and the sections stained with routine Hematoxylin and Eosin stain.Results: Commonest age group being 21-40years (41%) followed by 41-60years (40%). Gall bladder (GB) lesions are more common in females 175 (70%) and M:F ratio 1:2.2.Most commonest lesions were Chronic calculous cholecystitis constituting 155 cases (61%) followed by chronic cholecystitis 52 cases (21%). Cholelithiasis was associated with both Acute and Chronic Cholecytitis constituting 67%. Acute calculous cholecystits constitute 13 cases (5%) and Acute cholecystitis constitutes 10 cases (4%). In Congenital anomalies, 3 cases (1.2%) of Biliary atresia and 4 cases (1.2%) of choledochal cyst were diagnosed. 4 cases (1.6%) of Gall bladder carcinoma was diagnosed. Among these 3 cases were incidental gall bladder carcinoma (IGBC).Conclusions: cholecystectomy specimens should be subjected for histopathological examination to study various lesions of GB and to detect unsuspected incidental gall bladder cancer as cholecystectomy itself is the treatment for gall bladder cancer and also other lesions of GB associated with cholelithiasis.

scholarly journals Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

2012 ◽  
Vol 32 (2) ◽  
pp. 142-145 ◽  
Author(s):  
B Sigdel ◽  
R Nepali
Keyword(s):  
Tertiary Care ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Suppurative Otitis Media ◽  
Ear Diseases ◽  
Paediatric Age ◽  
One Year ◽  
A Prospective Study ◽  
Nose And Throat

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

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 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 Type and mode of diagnosis of carcinoma lung in a tertiary care centre: one year experience

2017 ◽  
Vol 5 (11) ◽  
pp. 4891
Author(s):  
Jayaprakash Balakrishnan ◽  
Sindhu Nair Prasannakumari ◽  
Ajith Achuthan ◽  
John Mathew
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Tertiary Care ◽  
Small Cell ◽  
Common Type ◽  
Ultra Sound ◽  
Tertiary Care Centre ◽  
Easy Method ◽  
One Year

Background: Lung cancer is one of the commonest cancers and cause of cancer related deaths all over the world. The reported incidence of adenocarcinoma is increasing globally and now reported to be the most common type of lung cancer. A panel of investigations are used for the diagnosis of lung cancer. Hence a study was planned to find out the pattern of malignancy and the most appropriate investigation for diagnosis. Objective of present study was to find out the type of carcinoma lung and to find out the best and easy method for diagnosis of carcinoma lung in a tertiary care centre.Methods: A hospital based cross sectional study was conducted in one unit of the Department of Pulmonary Medicine, Government Medical college, Thiruvananthapuram for a period of one year.148 diagnosed cases of carcinoma lung were enrolled. The type and the methods used for diagnosis were analysed.Results: Adenocarcinoma was the commonest malignancy 57 (38.5%), followed by squamous cell carcinoma 44 (29.7%) and small cell carcinoma 10 (6.75%). Rest of the cases 37 (25%) include non small cell carcinoma, poorly differentiated carcinoma and lymphoma. Diagnosis was established by FNA Lung in 46 (31.1%) patients and bronchoscopy and biopsy in 41 (27.7%). Other methods include TBNA 12 (8.1%), lymph node FNA/biopsy 11 (7.4%), pleural fluid cytology 24 (16.2%), sputum cytology and tru cut biopsy 14 (9.5%).Conclusions: The most common type of lung malignancy in present study was adenocarcinoma. Ultra sound guided FNAC lung and bronchoscopy biopsy were the best methods in present study to confirm the diagnosis.

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

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.  

scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY OF CLINICAL PROFILE IN ETIOLOGY OF ANEMIA IN ELDERLY-A HOSPITAL BASED STUDY IN A TERTIARY CARE CENTRE IN SOUTH INDIA

2021 ◽  
Vol 9 (09) ◽  
pp. 961-972
Author(s):  
K. Shivaraju ◽  
◽  
Karanam Sai Arun ◽  
Mandhala Saikrishna ◽  
◽  
...  
Keyword(s):  
Tertiary Care ◽  
The Elderly ◽  
Moderate Degree ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Total Study Population ◽  
Study Population ◽  
Poor Outcomes ◽  
One Year ◽  
Severe Degree

Background: Anemia is often considered as a normal physiological process that occurs with aging. but recently since past 2 decades anemia of any degree is being recognized as significant independent contributor to morbidity mortality and frailty in elderly patients. It is easy to overlook anemia in elderly as symptoms of anemia like fatigue, SOB etc are often attributed to aging process itself. many evidences accumulated states that anemia of any degree reflects poor health and increased vulnerability to poor outcomes. Materials and methods: This study was conducted in the department of internal medicine in a tertiary care hospital over a period of one year with sample size of 362 subjects satisfying the inclusion and exclusion criteria after taking the consent form. Results: Moderate degree anaemia was the commonest around, 65.6% followed by severe degree anemia 20.1%. Easy fatigability was the commonest symptom and pallor was the commonest sign of anaemia in elderly. Anemia is not always a consequence of aging. Anemia of unexplained etiology constituted 15.97% of total study population. Conclusion: Anaemia in elderly is a challenge and has to be approached in an organized manner for appropriate diagnosis and evaluation to look into its cause and plan management to improve the quality of life of the elderly persons.An effort should always be made to reach etiological diagnosis before instituting specific therapy.

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