Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder. It is estimated that approximately 90% of cholecystectomies in the United States are performed using a laparoscopic approach. The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.
Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed.
Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).
Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.
Karimian F, Aminian A, Mirsharifi R, Mehrkhani F. Surgical options in the management of cystic duct avulsion during laparoscopic cholecystectomy. Patient Saf Surg [Internet]. 2008;2(1):17. Available from: https://doi.org/10.1186/1754-9493-2-17 [PMid:18565237 PMCid:PMC2442050]
Duman K, Sezer K, Yilmaz F, Akin M. The clinical outcome of traditional laparoscopic cholecystectomy. Gaziantep Med J [Internet]. 2013;19(1):35-39. Available from: https://doi.org/10.5455/GMJ-30-2012-118
Passos MA, Portari-Filho PE. Antibiotic prophylaxis in laparoscopic cholecistectomy: is it worth doing? ABCD Arq Bras Cir Dig (São Paulo) [Internet]. 2016 Sep;29(3):170-172. Available from: https://doi.org/10.1590/0102-6720201600030010 [PMid:27759780 PMCid:PMC5074668]
Ivatury SJ, Louden CL, Schwesinger WH. Contributing Factors to Postoperative Length of Stay in Laparoscopic Cholecystectomy. JSLS J Soc Laparoendosc Surg [Internet]. 2011 Sep;15(2):174-178. Available from: https://doi.org/10.4293/108680811X13022985132254 [PMid:21902970 PMCid:PMC3148866]
Nuzzo G, Giuliante F, Giovannini I, Ardito F, D'Acapito F, Vellone M, et al. Bile Duct Injury During Laparoscopic Cholecystectomy. Arch Surg [Internet]. 2005 Oct 1;140(10):986-992. Available from: https://doi.org/10.1001/archsurg.140.10.986 [PMid:16230550]
Kreimer F, Cunha DJ, Ferreira CCG, Rodrigues TM, Fulco LG de M, Godoy ESN. Comparative analysis of preoperative ultrasonography reports with intraoperative surgical findings in cholelithiasis. ABCD Arq Bras Cir Dig (São Paulo). 2016 Mar 1;29(1):26-29. Available from: https://doi.org/10.1590/0102-6720201600010007 [PMid:27120735 PMCid:PMC4851146]
Ingraham AM, Cohen ME, Ko CY, Hall BL. A Current Profile and Assessment of North American Cholecystectomy: Results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg [Internet]. 2010 Aug 1;211(2):176-186. Available from: https://doi.org/10.1016/j.jamcollsurg.2010.04.003 [PMid:20670855]
Escarce JJ. Falling Cholecystectomy Thresholds Since the Introduction of Laparoscopic Cholecystectomy. JAMA J Am Med Assoc [Internet]. 1995 May 24;273(20):1581-1585. Available from: https://doi.org/10.1001/jama.1995.03520440035033 [PMid:7745770]
Legorreta AP. Increased Cholecystectomy Rate After the Introduction of Laparoscopic Cholecystectomy. JAMA J Am Med Assoc. 1993 Sep 22;270(12):1429-1432. Available from: https://doi.org/10.1001/jama.1993.03510120051029 [PMid:8371441]
Sheffield KM, Ramos KE, Djukom CD, Jimenez CJ, Mileski WJ, Kimbrough TD, et al. Implementation of a Critical Pathway for Complicated Gallstone Disease: Translation of Population-Based Data into Clinical Practice. J Am Coll Surg [Internet]. 2011 May 22;212(5):835-843. Available from: https://doi.org/10.1016/j.jamcollsurg.2010.12.047 [PMid:21398156 PMCid:PMC3350377]
Alponat A, Kum CK, Koh BC, Rajnakova A, Goh PMY. Predictive Factors for Conversion of Laparoscopic Cholecystectomy. World J Surg [Internet]. 1997 Jul 22;21(6):629-633. Available from: https://doi.org/10.1007/PL00012288 [PMid:9230661]
Dubois F, Berthelot G, Levard H. Coelioscopic cholecystectomy: Experience with 2006 cases. World J Surg [Internet]. 1995 Jul 22;19(5):748-752. Available from: https://doi.org/10.1007/BF00295921 [PMid:7571675]
Duncan CB, Riall TS. Evidence-Based Current Surgical Practice: Calculous Gallbladder Disease. J Gastrointest Surg [Internet]. 2012 Nov 18;16(11):2011-2025. Available from: https://doi.org/10.1007/s11605-012-2024-1 [PMid:22986769 PMCid:PMC3496004]
Ballal M, David G, Willmott S, Corless DJ, Deakin M, Slavin JP. Conversion after laparoscopic cholecystectomy in England. Surg Endosc [Internet]. 2009 Oct 6;23(10):2338-2344. Available from: https://doi.org/10.1007/s00464-009-0338-1 [PMid:19266237]
Wu YV, Linehan DC. Bile Duct Injuries in the Era of Laparoscopic Cholecystectomies. Surg Clin North Am [Internet]. 2010 Aug 6;90(4):787-802. Available from: https://doi.org/10.1016/j.suc.2010.04.019 [PMid:20637948]
Varela JE, Wilson SE, Nguyen NT. Laparoscopic surgery significantly reduces surgical-site infections compared with open surgery. Surg Endosc [Internet]. 2010 Feb 17;24(2):270-276. Available from: https://doi.org/10.1007/s00464-009-0569-1 [PMid:19533235]
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