Two eras of laparoscopic cholecystectomy: an experience of 3000 cases

Abstract

Background: Laparoscopic cholecystectomy (LC) a minimal invasive procedure is regarded as gold standard for gallstone disease for many years. With increase learning curve of surgeons, the incidence of complications of this procedure decreases significantly. The purpose of study was to compare the experiences of Laparoscopic cholecystectomy performed.Methods: It was a retrospective cohort study conducted in Surgical Department, Rawalpindi Medical College and author's surgical clinic. From 1st January 1998 to 31st December 2014. Total 3000 patients of Laparoscopic cholecystectomy were divided into 2 groups. First 1500 cases (operated between January 1998 to December 2007) in Group A and next 1500 cases (operated between January 2008 to December 2014) in Group B. Preoperative diagnosis, intraoperative findings and injuries especially incidence of CBD injuries with post-operative complications and their management were evaluated.Results: Out of 3000 cases 2585 (86.1%) were females and 415 (13.8%) were males. Total 18 (0.6%) cases had CBD injury during LC. 17 cases were in group A which decreased significantly to 1 case in Group B. Mean operative time was 30 minutes. Wound infection remained the most common postoperative complication.Conclusions: In our setup, the burden of laparoscopic cholecystectomy for symptomatic gallstones have increased with very low incidence of complications.

Early Postoperative Pain Intensity after Laparoscopic Cholecystectomy and Associated Risk Factors

“…Worldwide, Laparoscopic Cholecystectomy (LC) has replaced open cholecystectomy as the gold standard surgical procedure for symptomatic cholelithiasisas LC is safe, more effective, causes less pain and rapid recovery. 1,2 However, LC frequently results in significant early postoperative pain which warrants the need for rescue analgesia in PostAnaesthesiaCare Unit (PACU). 3,4 Early pain is the dominant complaint after LC, most intense on the day of surgery and the main reason for prolonged hospital stay and prolonged convalescence after surgery thereby increasing treatment cost and decreasing quality of life of patients.…”