Background: Major complications of laparoscopic cholecystectomy are bleeding and bile duct injury, and it is necessary to clearly identify structures endoscopically to keep bleeding and injury from occurring. The aim of this study was to depict the anatomic landmark in the Calots triangle, a vein (cystic vein), a constant feature which can help Laparoscopic surgeons to conduct a safe LC along with other precautions to be adopted. Methods: A total of 100 patients (58 male, 42 female) who underwent cholecystectomy were examined preoperatively by clinically. The origin and number of cystic veins and their relationship with the Calot triangle was evaluated. Results: The cystic veins were delineated intraoperatively in 80 of the 93 patients. The relationship between the cystic vein and the Calot triangle was identified in 80 (86.02%) of the 93 patients. One cystic vein was found in 53 (66.25%) patients, while multiple cystic veins were found in 27 (33.75%) patients. All these veins are above the cystic common bile duct junction. Conclusion: The configuration of the cystic veins and their relationship in the Calot triangle with cystic artery and cystic duct can be identified intraoperatively and used as a guideline for safe laparoscopic cholecystectomy.
BACKGROUNDVarious modifications have been tried in laparoscopic cholecystectomy since its introduction. One, two and three port LC have been performed on limited scale. Our aim was to compare three port LC with four port LC in patients with cholelithiasis. The main objective of this study was to evaluate the outcome of 3 port LC for treatment of cholelithiasis by comparing the result with 4 port LC with respect to safety and efficacy. MATERIALS AND METHODSIn this comparative study, a total of 150 patients of laparoscopic cholecystectomy for gall stone disease were studied by dividing them into two groups. The results were compared in terms of complications, conversion from 3 port to 4 port and from LC to open procedure, hospital stay, pain score, operative time, need of analgesia and bile duct injury. RESULTSA total of 150 patients of cholelithiasis were treated by laparoscopic cholecystectomy. Three port LC was performed in 60 (40%) patients and 4 port LC was performed in 90 (60%) patients. In group 1, 44.4% patients complained of mild pain and 55.5% experienced moderate-to-severe pain on VAS post-operatively, while in group 2 70% patients complained of mild pain and 30% patients complained of moderate-to-severe pain post-operatively. There was no bile duct injury reported in either group. However, in group 2 (3 port LC) 3 cases (5%) converted to 4 port LC and there was no conversion (open) reported in group 1 (4 port LC). CONCLUSIONIn this comparative study, we found that use of 3 port LC did not affect the procedure safety, conversion rate, operating time and complication rate. Three port LC is routine in our institute and used by experienced surgeons, needed fewer painkillers, shorter hospital stay and more cost effective. Various studies had shown that most of the gall bladder stone were asymptomatic and cholecystectomy was the gold standard surgical treatment of cholelithiasis. In the current laparoscopic era surgical treatment of cholelithiasis has changed, now laparoscopic cholecystectomy is the gold standard surgical treatment of cholelithiasis.The laparoscopic procedure was found to cause less scarring, shorter hospital stay and faster recovery than open procedure, but probably at the expense of a higher rate of 'Financial or Other Competing Interest': None. Submission 23-01-2018, Peer Review 17-02-2018, Acceptance 22-02-2018, Published 05-03-2018. Corresponding Author: Mahesh Chandra Pandey, 536/53 KMA, Durga Mandir, Madeh Gani, Sitapur Road, Lucknow-226020, Uttar Pradesh. E-mail: mp211177@gmail.com DOI: 10.14260/jemds/2018 bile duct injuries. 2 Post-operative pain and cosmesis and later complication like incisional hernia and intestinal obstruction should help to decide which technique is better. 3 Laparoscopic cholecystectomy is one of the most commonly performed operations in general surgery and considered standard care for symptomatic gall stone. 4 Laparoscopic cholecystectomy was first performed in 1987 by Philip Mouret. Laparoscopic cholecystectomy traditionally performed throu...
Objective: Infertility has been known to cause serious social and emotional problems in India. Microorganisms may be a primary cause for this infertility. This study was carried out to know the prevalence of microorganisms in the infertility couples of a tertiary caring teaching hospital. Methods:One thousands of couples were screened for the infertility test presented at the outpatient Department of Obstetrics and Gynaecology.The suspected infertility couples were tested for microbial contamination in their reproductive sample. Simultaneously, the demographic data of all patients were documented, and all the data were analyzed with SPSS 20 software.Result: From one thousand couples, 288 couples were found infertility symptoms, whereas 67.71% were primary infertility problems and rest were secondary. It is due to male factor (27.08%), female factor (50%), and both (4.86%) but 18.05 were unexplained. From vaginal swabs, 186 and semen 145 microbial colony were grown. However, Chi-square (χ 2 ) showed that there is no significant difference between the growth of microbial colony from semen or vaginal swap as p=0.06. Eight varieties of bacteria (387) and Candida albicans (37) were documented. Conclusion:With respect to older ages of the infertile couples, it is more chances to infections. Antibiotic should be prescribed to primary infertility couples and infections can be avoided the cross transmission during intercourse.
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