The aim of the study is to identify UGI pathologies in patients with cholelithiasis and association of these pathologies with a relief of symptoms in cholecystectomy patients. The study was conducted in 150 patients, who attended the surgical outpatient block or referred to our department from other departments and also known case of cholelithiasis by imaging studies. They were divided into a typical or atypical group based on their symptomatic presentation. UGI scopy was done on these groups, 2 days prior to surgery. Postoperatively patients were followed up on 7th, 21st and 42nd day and pain if any was assessed by NRS scaling method. Following results were noted. A female preponderance was seen (96 (64%)). Determining on age, 51 % of cases were seen among 31-50 years. UGI scopy revealed UGI pathologies in 22 among 92 (24%) patients who had typical symptoms of biliary colic, while 47 of 58 (81%) atypical presentations had UGI pathologies. The most common UGI pathology was gastritis and duodenitis (42 of 69 (61%)). Medical management was initiated for these pathologies prior to surgery. Postoperatively on 7th day 114 (76%) had no symptoms and 36 (24%) were symptomatic, of which 25 (69.4%) of them were UGI Positive preoperatively. Medical Management for their Gastrointestinal pathologies was continued and reviewed on 21st day of surgery which showed symptom relief in 31 of 36 patients (86.1%) and relief of symptoms in remaining 5 by 42nd day of surgery. Hence, this study recommend preoperative UGI scopy in cholelithiasis, which will help in postoperative management.
BACKGROUND Gastrointestinal anastomosis plays a pivotal role in gastrointestinal surgeries. GI anastomosis can be done either by hand-sewn or stapler method. Recently stapling devices have created a great impact in GI anastomosis. Aim of this study is to compare the outcome of stapler versus hand-sewn anastomosis in elective GI surgeries. MATERIALS AND METHODS In this study, 50 patients requiring elective GI surgeries were included after satisfying the inclusion criteria. Patients were divided into four groups based on the site of anastomosis. Comparison between hand-sewn and stapled anastomosis in each group in terms of duration of anastomosis, duration of surgery, return of bowel activity, starting of oral feeds, acute postoperative complications and length of post-operative hospital stay were done. RESULTS In this study, we found significant difference between hand-sewn and stapler anastomosis in each group in terms of duration of anastomosis, duration of surgery, return of bowel activity, oral feeds starting day and length of postoperative hospital stay. It was stapled anastomosis that took lesser time for anastomosis, total operating time, return of bowel activity and length of hospital stay. Chi-square test was used to differentiate acute post-operative complications, which was insignificant between hand-sewn and stapler method with p-value > 0.05. CONCLUSION Due to shortened operating time, staplers are favourable for patients with poor general condition who would not tolerate prolonged anaesthesia. The insignificant difference in acute postoperative complications suggests both hand-sewn and stapled method can be done with same safety and accuracy when done with proper technique.
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