In the treatment of common bile duct stones and palliative decompression of malignant strictures, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard. However, there are still concerns about procedure-related complications and patient discom- fort. To evaluate the pattern of the post ERCP complications. This prospective observational study was conducted at the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February 2017 to October 2017. A total of one hundred patients who were eligible for ERCP were included in this study but five patients were excluded due to cannulation failure. Clinical examination , biochemical, and radiological investigation were performed before and after ERCP to assess the complication that occurred. The majority of patients in this study were under the age of 50, with a mean age of 49.74 }14.07 years between the ages of 18 and 80 years. Males (54.7%) were predominant than female (45.3%) and male to female ratio was 1.21:1. The most common diagnosis was choledocholithiasis (58.9%) followed by proximal cholangiocarcinoma (13.7%), Carcinoma-gallbladder with biliary infiltration (8.4%), Distal cholangiocarcinoma (6.3%), Chronic calcific pancreatitis and Periampullary carcinoma each (3.2%), Suspected SOD & Chronic pancreatitis each (2.1%) and Worm in CBD and benign biliary stricture each (1.1%). In this study, the overall post-ERCP complication rate was 12.6% with pancreatitis accounting for 9.4%, bleeding accounting for 2.1%, and cholangitis accounting for 2.1%. From the study data it can be concluded that pancreatitis is the most frequent Post-ERCP complication. BSMMU J 2022; 15(1): 50-53
Port site infection(PSI) in laparoscopic surgery is not very uncommon. The main aim of this study was to assess the causes of port site infection and its management. This retrospective descriptive study was conducted on 48 patients from March 2019 to December 2020 who develop port site infection after laparoscopic cholecystectomies. Operation notes were analyzed; and swabs were taken for culture & sensitivity. Exploration and wound debride- ment with excisional biopsies were done under local anesthesia for all patients. All patients were followed-up for one year postoperatively. Factors as gender, site of infected port, types of microorganism, acute versus chronic cholecystitis, type of infection (superficial or deep infection) and intraoperative spillage of stones, bile or pus were analyzed . Age of the patients ranged from 15 years to 60 years and the mean age was 32.4 years. The female to male ratio is 2.2:1. Among the subjects, 56.25% patients suffered from acute and 43.75% suffered from chronic cholecystitis. 35.42% had a history of spillage of bile or stones in the abdomen. Considering the site of infection, 33.33% had only umbilical port site infection, 18.75% had only epigastric port infection and 47.92% had multiple port infection. 58.33% suffered from superficial infection and others had deep site infections. Histopathology reports showed granulomatous infection in case of 37.5% patients. So, special consideration should be taken in chronic deep surgical site infection as Mycobacterium tuberculosis could be the cause. BSMMU J 2021; 14(4): 99-103
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