Background: Cholecystectomy is the most frequently performed abdominal operation and currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in 90% cases of symptomatic gallstones in USA since 1992. The aim of the study was to determine results obtained with LC at our setup.
Methods: This observational case series study was conducted in department of General Surgery, Combined Military Hospital, Rawalpindi, from August 2009 to August 2011. The study participants were patients of both gender aged 14-75 years undergoing LC. Surgery was performed by consultant as well as resident surgeon. Demographic variables, intraoperative findings, mean operation time, hospital stay, conversion rate, morbidity and mortality were evaluated. Factors influencing rate of conversion were also studied.
Results: A total of 504 patients were included. Mean age was 42.64 years (range 14-75 years) with a female: male ratio of 3.9:1.2. Comorbidities were found in 36.7% patients. Main indication of surgery was symptomatic cholelithiasis (78.57%). Mean operative time was 40.1 ± 6.9 minutes which increased to 75.12 ± 8.9 minutes in converted cases (p-value .000). Mean hospital stay was 1.89 ± 1.1 days that significantly increased in converted cases (5.7 ± 1.6 days) (p-value .000). Major surgical complications occurred in 3.17% patients. Common bile duct injury (CBDI) was found in 04 cases (0.79%). Conversion to laparotomy was required in 3.97% cases. Factors that influenced the rate of conversion included: age > 60 years, acute cholecystitis, coexisting diseases, ASA grade III/IV and inexperienced surgeon (p-value .000). Total complication rate was 3.56%, morbidity being 3.17% and mortality 0.39%.
Conclusion: Laparoscopic cholecystectomy offers shorter hospital stay and low morbidity/mortality. The operative time is short and procedure is standard, safe and effective method both for uncomplicated and complicated cholelithiasis.
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BMJ Surg Interv Health Technol
January 2025
Department of Surgical Oncology, Kanazawa Medical University, Kahoku-gun, Japan.
Objectives: The advantages of indocyanine green (ICG) fluorescence cholangiography have been emphasized, but its disadvantages remain unclear. This study investigated the advantages and disadvantages of this modality, particularly the optimal timing of administration of ICG fluorescence.
Design: This was a retrospective analysis of prospectively collected patient data.
Cureus
December 2024
General Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Objective: The study aimed to investigate the rate of conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy (OC) in our population and determine the potential risk factors associated with it. Understanding these factors helps surgeons predict complex cases and plan surgeries, reducing patient risks and improving outcomes.
Methodology: A cross-sectional observational study was conducted from June 1, 2022, to May 31, 2023, at Hayatabad Medical Complex, Peshawar, on 349 patients undergoing elective LC.
Surg Pract Sci
June 2024
Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA, 72205.
Background: While previous literature has shown that resident involvement increases operative time, the influence of resident involvement on operative time is generally not considered in current methods of case time predictions or operating room planning. Furthermore, evidence of prolonged case times based on the level of the assisting resident is yet scarce. We hypothesized that operative time would increase with the post-graduate year of assisting residents as they gain more autonomy in the operating room.
View Article and Find Full Text PDFBackground The critical view of safety (CVS) is a critical technique to minimize the risk of bile duct injuries (BDIs) during laparoscopic cholecystectomy (LC). This study evaluated the rate of CVS achievement and examined factors influencing its success. Methods This prospective study included 97 patients undergoing LC.
View Article and Find Full Text PDFCureus
December 2024
General Surgery, Dr. Dnyandeo Yashwantrao Patil Medical College, Hospital and Research Centre, Dr. Dnyandeo Yashwantrao Patil Vidyapeeth (Deemed to be University), Pune, IND.
Aim: This study aims to evaluate the accuracy of ultrasonography (US) by comparing preoperative ultrasonographic findings with intraoperative observations during laparoscopic cholecystectomy (LC).
Materials And Methods: An observational analytical study was conducted at a tertiary hospital in Pune over two years and included 98 patients aged 20-80 with symptomatic cholelithiasis confirmed by US. Preoperative parameters assessed included gallstone number, gallbladder volume, wall thickness, and pericholecystic fluid.
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