Background: One of the most common reasons for admission to hospital is cholecystectomy and it has a mortality rate of 0.45% to 6%. Many risk factors have been found to be associated laparoscopic cholecystectomy that make it difficult like advance age, male gender, fever, obesity, previous abdominal surgeries, thick gall bladder lining, distention of bladder, presence of gall stones. There have been different scoring systems in literature that determine the risk of conversion to open cholecystectomy. The aim of present study is to determine the role of scoring system in predicting difficult laparoscopic surgery.Methods: The present prospective study was conducted for a period of 1 year in the Department of Surgery at Guru Gobind Singh Medical College, Faridkot, Punjab. The study included all the patients with symptomatic gall stones reporting to the OPD of the hospital. Patients were categorized into two groups after the surgery. Group I included patients who underwent successfully laparoscopic cholecystectomy and group II included those who were converted into an open case. In this study all the entities were provided with a score. Patients with score less than 4 were grouped as difficult. At the end of the study all the data were analyzed to see how scoring system can predict which patients will have easy or difficult laparoscopic cholecystectomy based on postoperative scoring. All the data was recorded in a tabulated form and analyzed using SPSS software.Results: The present prospective analytical study involved 112 subjects; out of these 94 were males and 18 females. The mean age of subjects was 48.2±3.7 years. There were 98 patients in Group I and 8 patients in group II who had didn’t show presence of peri cholecystic fluid. There was 1 patient in Group I and 5 patients in group II who had peri cholecystic fluid on ultrasound. There were 104 subjects with gall was thickness less than 4 mm. There were 95 patients in Group I and 9 patients in group II who had who had who had bladder wall thickness of less than 4 mm.Conclusions: The scoring tool evaluated in our study is useful in evaluating the risk of conversion of laparoscopic cholecystectomy into open cholecystectomy.
Introduction: Appendicectomy is one of the most common acute surgical emergency. Laparoscopic appendicectomy was first reported well before laparoscopic cholecystectomy, the market penetration is very poor. Role of laparoscopic appendicectomy remains controversial even after 30 years of inception. The present study is designed to assess these conflicts. Methods: 60 patients admitted in department of surgery with diagnosis of acute appendicitis, recurrent appendicitis and those kept for interval appendicectomy were randomly divided into two groups A and B. The patients in group A were subjected to laparoscopic appendicectomy and patients in group B underwent open appendicectomy. Results: Mean duration of surgery in LA was 41.78+ 13.55 mins, in OA was 61.66+ 25.25 and 102+ 3.54 mins for converted group. Postoperative pain was significantly less in patients operated with laparoscopic technique (3.18+ 1.09) as compared to OA (4.76+ 2.03) group as evident by number of analgesic requirement. Mean length of stay was shortest in LA group 2.5 + 1.07 days, followed by OA 4.833 + 2.11 days and 8.5 + 3.54 in converted group. Conclusion: Laparoscopic appendicectomy is having less complications as compared to open appendicectomy.Hence laparoscopic appendicectomy also decreases the morbidity associated with operative procedure , wound infection , paralytic ileus and prolonged hospitalization.
Insertion of first port and creation of pneumoperitoneum is a key step in laparoscopic surgery. A significant number of complications can be avoided by safe insertion of primary port. Various techniques of umbilical port insertion and their safety have been mentioned in literature. Closed method by using Veress needle is a blind procedure. Studies have shown that vascular injuries are more common with the Veress needle. Hasson first introduced the open technique of port insertion under direct vision. We used a modified open technique and analyzed the safety and efficacy in 80 cases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.