scholarly journals Frequency of Incidental Findings on Diagnostic Laparoscopy in Patients Undergoing Elective Laparoscopic Cholecystectomy

2021 ◽  
pp. 227-231
Author(s):  
Nazia Khatoon Soomro ◽  
Sandesh Kumar ◽  
Karim Bux Bhurgri ◽  
Ahmed Hussain Pathan ◽  
Altaf Ahmed Talpur
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Incidental Findings ◽  
Diagnostic Laparoscopy ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
Chronically Ill ◽  
Surgical Trauma ◽  
Care Hospital ◽  
Cross Sectional ◽  
Elective Laparoscopic Cholecystectomy

Objective: To determine the frequency of incidental findings on diagnostic laparoscopy in patients undergoing elective laparoscopic cholecystectomy at tertiary care hospital Jamshoro. Study design: This is a descriptive cross sectional study. Setting: Study carried out at department of general surgery, Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro from 1st February 2019 to 30th July 2019. Materials and methods: A total of 164 patients of both gender undergoing diagnostic laparoscopy in patients of laparoscopic cholecystectomy were included in the study. Laparoscopy was done under general anesthesia in all patients. The whole of peritoneal cavity was sequentially                 visualized using trendelenberg and reverse trendelenberg positions, and right or left tilt as      required. Results: Age range in this study was from 20 to 79 years with mean age of 43.622±9.31 years. 40.2% patients were of male gender and 59.8% patients were females. Peritoneal band & adhesions was seen in 9.8% patients, Ovarian Cyst 5.5%, Abdominal Tuberculosis 19.5% and Gall Bladder Carcinoma was 3%. Conclusion: We conclude that laparoscopy is very safe, can obviate the need for a full exploratory laparotomy & minimize the surgical trauma in chronically ill patients.

scholarly journals An analysis of postoperative adverse events following laparoscopic cholecystectomy in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2533
Author(s):  
Ramanuj Mukherjee ◽  
Vaibhav Agarwal ◽  
Arup Mohanta ◽  
Gouri Mukhopadhyay ◽  
Sudipta Samanta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Adverse Events ◽  
Tertiary Care ◽  
Unintentional Injury ◽  
Common Adverse Event ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
Life Threatening

Background: Being one of the most commonly performed surgery in the modern era, post-operative complications following laparoscopic cholecystectomy deserve special mention. Though not very life threatening, they are quite common. Considering these aspects, this study aims to identify them and possibly a potential remedy for decreasing the incidence in the future.Methods: This is a retrospective, institution-based, observational and cross-sectional analysis conducted in R.G. KAR Medical College and Hospital over 5 years on 1000 patients undergoing surgery. Here we intend to observe the adverse events following laparoscopic cholecystectomy in the post-operative period.Results: Most of the complications were seen in the age group greater than 40 years(63%) followed by the age group 30-40 years (26%).Adverse events were much more common in females (85%) followed by males (15%). The symptoms appeared mostly during 3-7 days post operatively (57%) followed by 20% within the first 6 hours. Non-specific abdominal pain (28%) was the most common adverse event followed by port-site infection in 16.5% cases.Conclusions: Proper pre-anaesthetic check-up with proper instrument handling with proper caution and before closing confirmation of proper placement of clip and no other unintentional injury anywhere can decrease the post-operative complication.

scholarly journals Assessment of different stress responses after laparoscopic and open cholecystectomy in patients attending tertiary care hospital, Bhuj, Gujarat, India: a prospective study

2017 ◽  
Vol 4 (5) ◽  
pp. 1575
Author(s):  
Bhavin Kothari ◽  
Gyaneshwar Rao
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Stress Responses ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Serum Cortisol ◽  
The Body ◽  
Surgical Trauma ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Reactive Protein

Background: Surgical trauma by incision and dissection of tissue stimulates the body to respond proportionately to the extent of injury. This study was conducted with an aim to compare metabolic and inflammatory responses after laparoscopic and open cholecystectomy namely serum cortisol and C-reactive protein levels before and after operation at Bhuj, Kutch, India.Methods: Present study was non-randomized, and comparative study carry out in the General Surgery Department at Gujarat Adani prospective institute of Medical Science, Bhuj, Kutch, Gujarat, India for an era of two years. One hundred and two patients were included in this study and were divided into two groups of open and laparoscopic cholecystectomy. Out of these 102 patients, 41 undergo open cholecystectomy and 61 laparoscopic cholecystectomy. Preoperative, intraoperative, postoperative and anesthetic medications were consistent in all the patients.Results: It was found that metabolic responses like serum cortisol were significantly higher after open procedure 6 hours and 48 hours postoperatively. Similarly, inflammatory response indicator C-reactive protein was raised significantly higher 48 hours after open as compared to laparoscopic cholecystectomy.Conclusions: Open cholecystectomy caused further tissue responses as compared to its laparoscopic alternative.

scholarly journals A COMPARATIVE STUDY OF SERUM TOTAL CHOLESTEROL IN PRE AND POST-CHOLECYSTECTOMY PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 9 (03) ◽  
pp. 95-99
Author(s):  
Kalbe Jawad ◽  
◽  
Adil Rahman ◽  
Somendra Pal Singh ◽  
Pradeep Sharma ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Total Cholesterol ◽  
Gallbladder Disease ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Quality Standard ◽  
Mean Value ◽  
Serum Total Cholesterol ◽  
Surgical Trauma ◽  
Care Hospital

Background:Laparoscopic cholecystectomy has many advantages over laparotomy like smaller incisions, reduced surgical trauma, less post-operative pain, faster recovery time, shorter hospital stay, and faster return to normal activities or routine work. So, it is considered as the gold standard for surgical treatment of benign gallbladder disease like cholelithiasis.The aim of this study was to elucidate the association of serum total cholesterol with cholelithiasis patients and effect of cholecystectomy on the same by laparoscopic procedure. Methodology: This study was conducted prospectively on 109 patients in a tertiary care hospital in eastern Uttar Pradesh, India. From January 2019 to December 2019, patients admitted for cholecystectomy in General surgery ward of this hospital were included in this study. Fasting blood samples of the patients were collected firstbefore surgery and then 12-24 hours after surgery and were analyzed in the biochemistry laboratory of the institute after proper control and calibration, meeting the quality standard of the laboratory. Values of serum total cholesterol thus obtained were compared with each other. Results: In our study, 84.4% patients were females with mean age of 43.1 years and 15.6% patients were males with mean age of 40.8 years. A reduction in mean value of serum total cholesterol was noted pre-operatively from 221.1 mg/dL to 203.5 mg/dL post-operatively. Conclusion: From our study, we concluded that laparoscopic cholecystectomy is beneficial in lowering down the serum total cholesterol and hence reduces the risk factors for associated diseases.

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 Evaluation of the Bleeding Complications in Laparoscopic Cholecystectomy in a Tertiary Care Hospital: A Cross-Sectional Study

2021 ◽  
pp. 170-175
Author(s):  
Muhammad Kamran Ansari ◽  
Inayat Ali Zardari ◽  
Shazia Awan ◽  
Shahnawaz Laghari ◽  
Naeem Karim Bhatti ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Early Recognition ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Bleeding Complications ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mesenteric Vessel

Objective: To determine the frequency of various sources of bleeding in laparoscopic cholecystectomy with special preference to gallbladder bed excluding port site. Methods: This cross-sectional study was consisted of 163 patients admitted through the outpatient department from Peoples Medical College Hospital Nawabshah. Ultrasound of abdomen was done as diagnostic modality and for assessment of gallstone disease. Finally the cases of gallstone were operated through laparoscopic cholecystectomy procedure and observed for sources of bleeding. Results: Out of 163 patients included in this study 138(84.7%) were female and 25(15.3%) patients were male; with female to male ratio of 5.52:1. The mean age was 41.85±7.83 years. Common sources of bleeding in laparoscopic cholecystectomy from liver bed side were 44(27%) cases followed by cystic artery in 17(10.4%) cases, hepatic artery and mesenteric vessel in 1(0.6%) case was observed. Conclusion: Bleeding during laparoscopic cholecystectomy are almost equally common and can prove to be lethal if not identified and managed during the operation. Good surgical technique, awareness and early recognition and management of such cases are keys to success when dealing with this problem.

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