DOES EARLY LAPAROSCOPIC CHOLECYSTECTOMY AFTER ERCP OFFERS SIGNIFICANT BENEFIT IN SURGICAL OUTCOME? A COMPARATIVE STUDY BETWEEN EARLY AND LATE GROUPS

2021 ◽  
pp. 59-61
Author(s):  
Anshul Mathur ◽  
Ketan Patel ◽  
Jitendra Kumar Mangtani ◽  
K.K. Dangayach
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Endoscopic Retrograde ◽  
Endoscopic Retrograde Cholangiopancreaticography ◽  
Early Laparoscopic Cholecystectomy ◽  
Conversion Rates ◽  
Group A ◽  
Group B

Introduction:- Endoscopic retrograde cholangiopancreaticography (ERCP) prior to Laparoscopic Cholecystectomy(LC) is most commonly practiced strategy worldwide for management of co-existing cholelithiasis with choledocholithiasis. The time interval between Endoscopic Retrograde Cholangiopancreaticography (ERCP) and Laparoscopic cholecystectomy (LC) is questionable and varies from 1 day to 6 weeks in different studies. Aims and objectives:- To compare two groups of patients managed with laparoscopic cholecystectomy (after ERCP), EARLY(24 to 72 hours), and LATE(> 6weeks) in terms of mean operative time in minutes, intraoperative difculties, conversion rates to open cholecystectomy, conversion rates to open cholecystectomy, drain insertion required or not, postoperative complications, and duration of hospital stay. Materials and methods:- A prospective randomized comparative study was conducted on 70 patients who presented with concomitant cholelithiasis with choledocholithiasis over a period of January 2019 to June 2020 at the Department of General Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. After ERCP and stone retrieval patients were randomised into 2 groups using sealed envelope method. Group A underwent early laparoscopic cholecystectomy (24 to 72hours) and Group B underwent late laparoscopic cholecystectomy (after 6 weeks). Data collected, statistical analysis done, results and observations concluded. Result:- We found that mean operative time, intraoperative difculties, post operative complications and mean hospital stay in days were signicantly higher in Group B as compared to Group A. Though the conversion rates to open procedure and requirement of drain insertion were comparatively higher in Group B but were found to be statistically non signicant. Conclusion:- We hereby conclude that early laparoscopic cholecystectomy (24 to 72 hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP) is better as compared to late laparoscopic cholecystectomy (>6 weeks) after ERCP in patients of cholelithiasis with coexisting choledocholithiasis. So, we recommend performing early Laparoscopic Cholecystectomy (24-72hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP)

scholarly journals Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

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.

scholarly journals A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 253 ◽  
Author(s):  
Pramod Singh ◽  
Sumit Kumar Gupta ◽  
Mukesh Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
City Hospital ◽  
Site Infection ◽  
First Choice ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.

scholarly journals BENEFITS OF EARLY POST-ERCP LAPAROSCOPIC CHOLECYSTECTOMY: A SINGLE CENTRE PROSPECTIVE STUDY

2021 ◽  
Vol 12 (3) ◽  
Author(s):  
Farhan javed ◽  
Saira Saleem ◽  
Ayesha Rehman ◽  
Faiza Wattoo ◽  
Nadia Bano ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Statistical Tests ◽  
P Value ◽  
Cross Sectional ◽  
Increased Risk ◽  
Group A ◽  
Study Population ◽  
Group B

ABSTRACT: BACKGROUND & OBJECTIVE: Laparoscopic cholecystectomy (LC) following Endoscopic retrograde cholangiopancreatography (ERCP) is associated with an increased risk of complications. ERCP is associated with increased incidence of complications during LC. Surgery may be performed in same anesthesia with ERCP or up to 6 weeks later. We aimed to determine the benefits of performing LC within 72hrs of ERCP. METHODOLOGY: After institutional ethical approval this prospective cross-sectional study was performed at Madinah Teaching Hospital Faisalabad from April 2019 to June 2020. By performing convenience sampling, all patients undergoing LC after uneventful ERCP in our hospital were included. Study population was divided based on interval between ERCP and Cholecystectomy; Group-A had LC within 72hrs of ERCP, Group B had LC in same hospital stay after 72hrs and Group-C patients were discharged after ERCP and readmitted for LC. Data was collected using custom designed questionnaire, tabulated using Microsoft Excel 2016 and subjected to statistical tests to compare outcomes. Primary outcome was incidence of complications, while operative time, hospital stay and cost were considered as secondary outcomes. p-value of <0.05 was considered significant. RESULTS: Total 75 patients were included in study, 32 in Group-A, 20 in Group-B and 23 in Group-C. Average age was 44.987 ± 14.819 and study population was predominantly female (86.67%). Complication rate, duration of hospital stay and average cost were less in Group A as compared to other groups (p<0.05). Mean operative time in 3 groups was similar. CONCLUSION: LC within 72hrs after ERCP provides superior results in terms of fewer complications, shorter hospital stays and lesser cost.

scholarly journals Operative Outcome and Patient Satisfaction in Early and Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Aly Saber ◽  
Emad N. Hokkam
Keyword(s):  
Patient Satisfaction ◽  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Patient’S Satisfaction ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Operative Outcome ◽  
Group A ◽  
Group B

Introduction. Early laparoscopic cholecystectomy is usually associated with reduced hospital stay, sick leave, and health care expenditures. Early diagnosis and treatment of acute cholecystitis reduce both mortality and morbidity and the accurate diagnosis requires specific diagnostic criteria of clinical data and imaging studies.Objectives. To compare early versus delayed laparoscopic cholecystectomy regarding the operative outcome and patient satisfaction.Patients and Methods. Patients with acute cholecystitis were divided into two groups, early (A) and delayed (B) cholecystectomy. Diagnosis of acute cholecystitis was confirmed by clinical examination, laboratory data, and ultrasound study. The primary end point was operative and postoperative outcome and the secondary was patient’s satisfaction.Results. The number of readmissions in delayed treatment group B was three times in 10% of patients, twice in 23.3%, and once in 66.7% while the number of readmissions was once only in patients in group A and the mean total hospital stays were higher in group B than in group A. The overall patient’s satisfaction was92.66±6.8in group A compared with75.34±12.85in group B.Conclusion. Early laparoscopic cholecystectomy resulted in significant reduction in length of hospital stay and accepted rate of operative complications and conversion rates when compared with delayed techniques.

scholarly journals Comparative Study of Conventional Electrocautery Versus Ultrasonic Dissector in Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 70-73
Author(s):  
Saad Bin Anis ◽  
Pir Muneeb Rehman ◽  
Farhan Ahmad ◽  
Umar Farooq
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Minimal Invasive ◽  
P Value ◽  
Single Incision Laparoscopic Surgery ◽  
Ultrasonic Dissector ◽  
Group A ◽  
Group B

Background: Laparoscopic cholecystectomy (LC) is very commonly performed for removal of gallstones. In routine, ultrasonic devices are used for laparoscopy involving the deeper operating fields, while electrosurgical devices are preferred for LC. However, nowadays both of these devices are used for LC. The objective of this study was to compare the surgical outcomes of ultrasonic dissector over conventional electrocautery in patients planned for LC. Material and Methods: This non-randomized clinical trial was conducted in general surgery unit, Jinnah hospital Lahore. The study duration was 15th January 2015 to 31st December 2016. In group A (n=100), patients were operated through three-port standard laparoscopic cholecystectomy and conventional electrosurgical cautery was used for dissection. While in group B (n=50), patients were operated through single incision laparoscopic surgery (SILS) and Harmonic dissector was used for sealing of cystic artery and cystic duct. SPSS version 23 was used for data analysis. Complications between electrocautery and ultrasonic dissector were compared using chi-square test/Fischer exact test and operative time was compared using student’s t-test with p-value ≤ 0.05 considered as statistically significant.Results: Out of 150 patients planned for laparoscopic cholecystectomy, 33 (22%) were males and 117 (78%) females. The mean age was 40±6.45 years with an age range of 12-80 years. In group A, intraoperative gall bladder perforation was found in 5 patients whereas in group B, there was only one patient with perforation. A total of 4 cases were converted to open cholecystectomy in group A due to difficult dissection in Calot’s triangle as compared to 1 case in group B. In group A, 3 cases had postoperative bile leakage in the drain. In two patients it settled over a period of 3 days. About 03 cases had wound infection in group A and 1 in group B. Mean operative time in group A was 42.2±8.93 minutes versus 35.7±4.85 minutes in group B (p-value 0.001).Conclusion: In this study, the rate of post-operative complications was similar between the two groups, but operative time was significantly shorter in the group B. Harmonic dissector enabled easy dissection of tissues with good hemostasis and less trafficking of instrument, avoiding use of clips and sutures during minimal invasive surgery.

scholarly journals Safety and feasibility of three port procedure in laparoscopic cholecystectomy

2019 ◽  
Vol 6 (6) ◽  
pp. 1975
Author(s):  
Vipin Gupta ◽  
Shailendra Pal Singh ◽  
Somendra Pal Singh ◽  
Anil Kumar Keshari ◽  
Anil Kumar Erry ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Standard Technique ◽  
Post Operative Pain ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic cholecystectomy is widely accepted gold standard technique for management of cholelithiasis and has undergone many refinements including decrease in size and number of ports. Many researchers have claimed that three-port laparoscopic cholecystectomy is safe and feasible method for management of cholelithiasis but still it is not performed widely by the surgeons. Objective of our study was to assess the safety and feasibility of three-port laparoscopic cholecystectomy by comparing the various defined parameters with the standard four-port laparoscopic cholecystectomy.Methods: The study included 100 patients and was divided equally in 2 groups. Patients in Group A underwent laparoscopic cholecystectomy by three-port technique and in Group B were operated by four-port technique. Patients in both the groups were compared in terms of operative time, intra-operative complications, post-operative pain, post-operative complications and cosmesis outcome.Results: The mean operative time was similar in both groups. Intra-op and post-op complications were also similar. 3 patients in Group A needed fourth port and 1 patient in both group required conversion to open cholecystectomy. Mean pain score and requirement of parentral analgesia was found to be lower in Group A. Duration of hospital was similar in both the groups. Patients in group A had slightly better cosmetic outcome.Conclusions: Three-port laparoscopic cholecystectomy is a minimally invasive, safe and feasible technique and is not difficult to master than other advanced techniques. In experienced hands, laparoscopy cholecystectomy can be initially started with three-ports and can be converted to four-port if rarely necessary.

Early Laparoscopic Cholecystectomy Is the Appropriate Management for Acute Gangrenous Cholecystitis

2011 ◽  
Vol 77 (4) ◽  
pp. 401-406 ◽  
Author(s):  
Sae Byeol Choi ◽  
Hyung Joon Han ◽  
Chung Yun Kim ◽  
Wan Bae Kim ◽  
Tae-Jin Song ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Early Operation ◽  
Duration Of Symptoms ◽  
Early Laparoscopic Cholecystectomy ◽  
Gangrenous Cholecystitis ◽  
Total Hospital Stay ◽  
Urgent Operation ◽  
Operation Group

Treatment of severe acute cholecystitis by laparoscopic cholecystectomy remains controversial because of technical difficulties and high rates of complications. We determined whether early laparoscopic cholecystectomy is appropriate for acute gangrenous cholecystitis. The medical records of 116 patients with acute gangrenous cholecystitis admitted to the Korea University Guro Hospital between January 2005 and December 2009 were reviewed. The early operation group, those patients who had cholecystectomies within 4 days of the diagnosis, was compared with the delayed operation group, who had cholecystectomies 4 days after the diagnosis. Of the 116 patients, 57 were in the early operation group and 59 were in the delayed operation group. There were no statistical differences between the groups with respect to gender, age, body mass index, operative methods, major complications, duration of symptoms, mean operative time (98 vs 107 minutes), or postoperative hospital stay. However, the total hospital stay was significantly longer in the delayed operation group. More patients underwent preoperative percutaneous cholecystostomy in the delayed operation group (3.5 vs 15.3%). Early laparoscopic cholecystectomy for acute gangrenous cholecystitis is safe and feasible. There is no advantage to postponing an urgent operation in patients with acute gangrenous cholecystitis.

scholarly journals COMPARISON OF OUTCOMES BETWEEN EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CALCULOUS CHOLECYSTITIS

2021 ◽  
Vol 71 (3) ◽  
pp. 796-800
Author(s):  
Muhammad Ismail ◽  
Nasir Mehmood Wattoo ◽  
Muhammad Qasim Butt ◽  
Fareeha Naz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operation Time ◽  
Acute Calculous Cholecystitis ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Calculous Cholecystitis ◽  
Post Operative Complications

Objective: To compare early versus delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of mean operative time, hospital stay, conversion rate to open surgery and post-operative complications. Study Design: Quasi experimental study. Place and Duration of Study: Army Liver Transplant Unit, Department of Surgery, Pak-Emirates Military Hospital Rawalpindi, from Jul to Dec 2018. Methodology: A total of 170 patients (85 in each group) diagnosed as a case of acute calculous cholecystitis who met the sample selection criteria were included. Group A patients underwent early laparoscopic cholecystectomy within 72 hours of admission while group B patients underwent conservative management followed by delayed laparoscopic cholecystectomy after 6 weeks. All patients were followed for operative time, hospital stay, per-operative difficulties encountered and post-operative complications. Results: Group A had a mean operation time of 43.9 ± 11.1 minutes, while group B had a mean operation time of 45.8 ± 10.1 minutes (p=0.83). The mean duration of hospitalization was 2.8 ± 1.1 days in group A and 5.3 ± 0.8 days in group B (p<0.001). Complications were measured at a frequency of 14.1% in group A and 5.9% in group B (p=0.07). Conclusion: Early laparoscopic cholecystectomy is better than delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of hospital stay and per-operative difficulties faced. The post-operative complications between the two groups are comparable.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

scholarly journals EPIDURAL ANAESTHESIA;

2012 ◽  
Vol 19 (06) ◽  
pp. 894-904
Author(s):  
CHOUDRY AMJAD ALI ◽  
RAHEEL AZHAR KHAN ◽  
AMJAD IQBAL ◽  
Tasadaq Khurshid
Keyword(s):  
Hospital Stay ◽  
General Anaesthesia ◽  
Urinary Retention ◽  
Epidural Anaesthesia ◽  
Recovery Time ◽  
Open Cholecystectomy ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Group A ◽  
Group B

Objective: To compare the, post op analgesia, vomiting, shivering, length of hospital stay, peri-operative haemodynamicchanges and recovery time in patient under going open cholecystectomy under general anaesthesia versus those receiving epiduralanaesthesia. Study design: Quasi experimental study. Place and duration of study: Combined Military Hospital Rawalpindi from 15 October2007 to 15 April 2008. Methodology: American Society of Anaesthesiology (ASA) physical status (PS) I and II patient of either genderundergoing un-complicated open cholecystectomy were randomly divided into two groups, group A (n=30) received general anaesthesia (GA)and group B (n=29) received thoracic epidural anaesthesia (EA). Patients of both the groups were assessed for peri-operative haemodynamicchanges, recovery time, post op analgesia, vomiting and length of hospital stay. Chi-square test was applied to compare the two groups andobtain P-value. P-value of less than 0.05 was considered significant. Results: 9 out of 30 patients (30%) of group “A” (general anaesthesia) and4 out of 29 patients (13.79%) in group “B” (epidural anaesthesia) had vomiting. Shivering was seen in 3 out of 30 (10%) in group “A” (generalanaesthesia) and 1 out of 29 (3.44%) patient in group “B” (epidural anaesthesia). Urinary retention was seen in 1 out of 30 (3.33%) in group “A”(general anaesthesia) and 8 out of 29 (27.5%) in group “B” (epidural anaesthesia). Urinary retention was relieved by psychotherapy. None ofthe patient required catheterization. Post operative recovery from surgery was determined by gastrointestinal motility (passage of flatus andstart of oral sips). In group “A” (general anaesthesia) 6 patients (20%) started oral sips in first post operative day, 16 patients (53.33%) onsecond post operative day, 8 patients (26.66%) in third post operative day. In the group “B” (epidural anaesthesia) 13 patients (44.8%) startedoral sips on first post operative day, 15 (51.72%) on second post operative day and one patient (3.44%) on third post operative day. Regardingthe length of hospital stay 17 patient (56.66%) of group “A” (general anaesthesia) were discharge by third post operative day and 22 patient(75.77) were discharge by third post operative day in group “B” (epidural anaesthesia). Conclusions: The use of intra-operative epiduralanaesthesia combined with postoperative epidural analgesia was found to be associated with reduction in the post operative pain and vomitingin patients under going open cholecystectomy.

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