Backgrounds/AimsPrevious studies have evaluated quality of life (QoL) in patients who underwent laparoscopic cholecystectomy (LC) for cholelithiasis. The purpose of this study was to evaluate QoL after index admission LC in patients diagnosed with acute cholecystitis (AC) using the Gastrointestinal Quality of Life Index (GIQLI) questionnaire.MethodsPatients ≥21 years admitted to Tan Tock Seng Hospital, Singapore for AC and who underwent index admission LC between February 2015 and January 2016 were evaluated using the GIQLI questionnaire preoperatively and 30 days postoperatively.ResultsA total of 51 patients (26 males, 25 females) with a mean age of 60 years (24–86 years) were included. Median duration of abdominal pain at presentation was 2 days (1–21 days). 45% of patients had existing comorbidities, with diabetes mellitus being most common (33%). 31% were classified as mild AC, 59% as moderate and 10% as severe AC according to Tokyo Guideline 2013 (TG13) criteria. Post-operative complications were observed in 8 patients, including retained common bile duct stone (n=1), wound infection (n=2), bile leakage (n=2), intra-abdominal collection (n=1) and atrial fibrillation (n=2). 86% patients were well at 30 days follow-up and were discharged. A significant improvement in GIQLI score was observed postoperatively, with mean total GIQLI score increasing from 106.0±16.9 (101.7–112.1) to 120.4±18.0 (114.8–125.9) (p<0.001). Significant improvements were also observed in GIQLI subgroups of gastrointestinal symptoms, physical status, emotional status and social function status.ConclusionsIndex admission LC restores QoL in patients with AC as measured by GIQLI questionnaire.

Spigelian hernia with concurrent inguinal hernia is not uncommon. The hernia location makes conventional laparoscopic repair challenging and this is commonly repaired by the open method. We present the technical considerations and feasibility, as well as literature review, of such a hernia repaired via a minimally invasive fashion. We performed a laparoscopic transabdominal preperitoneal hernia repair for a 59‐year‐old woman who presented with symptomatic irreducible large Spigelian‐inguinal complex hernia, with a hernia neck of 4 cm on computed tomography scan. The hernia contents were reduced transabdominally and subsequently, the preperitoneal space was created via a transabdominal preperitoneal method to allow for hernia defect closure and subsequent mesh placement. The patient was discharged on postoperative day 2 without complication. At 6 months follow‐up, she had no complications or recurrence. With increased experience, the laparoscopic repair of complex Spigelian‐inguinal concurrent hernias is safe and feasible.

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