Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

Abstract

Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder. It is estimated that approximately 90% of cholecystectomies in the United States are performed using a laparoscopic approach. The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital. 
 Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed.
 Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%). 
 Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

Profile of Laparoscopic Cholecystectomy: A Cross-Sectional Study From Tertiary Centre of Central Nepal

“…In our study, the ratio of females to males was 4.18:1 which was similar to the study done in Baghdad. 8,9 The mean age of the patient was 47.13 years which was comparable with the study done in Nepal 3,10 , India 11 , and Greece 12 however, study done in Pakistan had a mean age of 39 years which was 8 years earlier than our population. 13 This difference might be due to dietary and lifestyle variations which promote gallstone formation among those populations.…”

Propensity score-matched comparison of safety outcomes between high-risk and low-risk patients towards early hospital discharge after laparoscopic cholecystectomy

“…However, none of the patients in this study had a significant vascular injury. The incidence of conversion to open surgery has been reported to range from 2.6 to 7.7% 1 , 25 , 26 ; however, the conversion rate in this study was slightly lower at 2.4%, with severe adhesion as the primary reason. Reoperation within 30 days was necessary in four patients due to various complications: (i) bleeding from the gallbladder bed on day 0, (ii) hepatic flexure colon injury on day 1, (iii) ileal injury on day 2, and (iv) total transection of the common hepatic duct on day 10.…”

“…Gallstone disease affects 10–20% of adults 1 . with laparoscopic cholecystectomy (LC) being the standard treatment 2 , 3 .…”

Pneumoperitoneum with Muyo Hook on Laparoscopic Cholecystectomy

“…For symptomatic cholelithiasis, the standard gold treatment for gallstones is laparoscopic cholecystectomy. 8 The removal of gallbladder disease with laparoscopic cholecystectomy is a minimally invasive surgical operation. This method has supplanted the open approach for regular surgery to remove the gallbladder since the mid-1990s.…”