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.

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.

A STUDY OF THE CLINICAL PROFILE OF PATIENTS WITH HYPOSPADIAS AT A TERTIARY CARE CENTRE AT KANPUR, INDIA

2021 ◽  
pp. 65-66
Author(s):  
R. K. Maurya ◽  
Shraddha Verma ◽  
R. K. Tripathi ◽  
Amit Yadav
Keyword(s):  
Prospective Observational Study ◽  
Undescended Testis ◽  
Tertiary Care ◽  
Care Centre ◽  
Common Site ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Treatment History ◽  
Congenital Hernia ◽  
Distal Hypospadias

Background: Hypospadias is a common congenital anomaly in which the anterior urethra is incompletely developed and does not extend to the tip of the glans penis. The present study was aimed to study the clinical prole of hypospadias. Settings and Design:This was a prospective, observational study. Methods: This prospective study was conducted at Department of General Surgery, LLR & Associated Hospitals, GSVM Medical College, Kanpur, India, from January 2019 to October 2020, on 72 patients of hypospadias, after taking clearance from the Institutional Ethical Committee, and taking proper informed consent for participation. Data collected for each patient included age, sex, demography, symptoms with duration, and relevant past and treatment history. Results: The most common age of presentation was between 1-5years of age (48.61%, n=35). Distal hypospadias (DH) was the most common site. (47.22%, n=34). 4.16% (n=3) patients presented with urethrocutaneous stula. Chordee was more commonly seen in patients with mid & proximal penile hypospadias (64.70%, n=33). In the present study, 4.1% (n=3) had associated undescended testis, 4.1% (n=3) had an associated bid scrotum and 1.3% (n=1) had an associated congenital hernia. Conclusions: Most cases of hypospadias present before 10 years of age. Distal hypospadias is the most common type. Chordee is associated most commonly with proximal penile and mid penile hypospadias. It may also be associated with other congenital anomalies like, undescended testis, bid scrotum or congenital hernias

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 EPIGASTRIC VS. UMBILICAL PORT FOR RETRIEVAL IN LAPAROSCOPIC CHOLECYSTECTOMY : WHICH IS BETTER

2020 ◽  
pp. 1-2
Author(s):  
Zayd Ashok ◽  
Priyanka pant
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Standard Treatment ◽  
Single Incision ◽  
Technical Difficulty ◽  
Port Site ◽  
Post Operative Pain ◽  
Port Site Hernia ◽  
Day By Day ◽  
Site Pain

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.

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