Volume: 9 Issue: 2
Year: 2021, Page: 15-18, Doi: https://doi.org/10.47799/pimr.0902.04
Received: Jan. 5, 2021 Accepted: Jan. 28, 2021 Published: Jan. 28, 2021
Background: Laparoscopic cholecystectomy is gaining popularity for the surgical treatment of gallbladder diseases. The technique has advantages of safe surgery, minimal complications, lower duration of hospital stay, and early return to normal activities. We in the current study tried to evaluate the outcomes of laparoscopic cholecystectomies done in our tertiary care teaching hospital.
Methods: Based on the inclusion and exclusion criteria n=40 cases were identified and treated with laparoscopic cholecystectomy. A complete history which included the pasthistory, family history, socioeconomic status, nature of symptoms, diet history was obtained. All the patients underwent a complete clinical examination. The investigations carried out were complete blood picture, bleeding time, clotting time, ECG, LFT, KFT, FBS, blood groups, chest x-ray, and Ultrasound scan of the abdomen. All cases were operated as per the standard procedures.
Results: The most common sign recorded in the cases was pain in right hypochondrium. Out of n=40 cases, 95% were present with pain 5% was without pain. Clinical jaundice was found in 10% of cases and tenderness was found on examination in 95% of cases. USG showed the presence of multiple stones was in 76% of cases, thickening of the gall bladder was in 80% cases and presence of mass was detected in 8% of cases. The followup period was 3 months in which no complications were reported.
Conclusion: The study found that most of the cases of cholelithiasis now occurring across the spectrum of different ages. The diagnosis has now become easy with the presence of ultrasonography which has sensitivity and specificity. The motto of safe surgery, low morbidity, and early back to work is best done with laparoscopic cholecystectomy.
Keywords: Laparoscopic cholecystectomy, cholelithiasis, gallbladder disease
1. K Park. Man and medicine towards health for all. Park’s Textbook of preventive and social medicine, K Park, Banarasi Das Publishers. 17th edition Nov 2002, 1-10.
2. BlumgartLH.Y Fong Editors. Gallstones and gallbladder.Textbook of Surgery of liverand biliary tract,Harcourt Publishers 2002; Vol 1:617-791.
3. Rakesh Tendon, Siddharth N Shah. Diseases of the gallbladder and biliary tract. API Text ofmedicine,7th edition, 2003;642-644.
4. David.E., Johnston Marshall.M.Kaplan.Pathogenesis and treatmentof gallstones. The new England journal of medicine. 1997;6(328):412-421.
5. Yio XY, Jin BW, Yin FZ, Li XJ. Bile secretory immunoglobulin A in biliaryinfection and cholelithiasis. Gastroenterology 1992;102: 1000-08.
6. Trotman BW, Petrella EJ, Soloway RD, Sanchez HM, Morris TA III, MillerWT. Evaluation of radiographic lucency or opaqueness of gallstones as ameans of identifying cholesterol or pigment stones: correlation of lucency oropaqueness with calcium and mineral.Gastroenterology 1975; 68:1563-66.
7. Dolgin SM, Schwartz JS, Kressel HY, et al. Identification of patients with cholesterol or pigment gallstones by discriminant analysis of radiographicfeatures. N Engl J Med 1981; 304:808-11.
8. Kapoor T, Wrenn SM, Callas PW, Abu-Jaish W. Cost Analysis and Supply Utilization of Laparoscopic Cholecystectomy. Minim Invasive Surg. 2018; 7838103.
9. Strasberg SM. Tokyo Guidelines for the Diagnosis of Acute Cholecystitis. J Am Coll Surg. 2018;227(6):624.
10. Blythe J, Herrmann E, Faust D, Falk S, Edwards-Lehr T, Stockhausen F, Hanisch E, Buia A. Acute cholecystitis - a cohort study in a real-world clinical setting (REWO study, NCT02796443). Pragmat Obes Res. 2018;9:69-75.
11. Kose SH, Grice K, Orsi WD, Ballal M, Coolen JML. Metagenomics of pigmented and cholesterol gallstones: the putative role of bacteria. Sci Rep. 2018 Jul 25;8(1):11218.
12. Sarawagi R, Sundar S, Raghuvanshi S, Gupta SK, Jayaraman G. Common and Uncommon Anatomical Variants of Intrahepatic Bile Ducts in Magnetic Resonance Cholangiopancreatography and its Clinical Implication. Pol J Radiol. 2016;81:250-5.
13. Sherwinter DA. Identification of anomalous biliary anatomy using near-infrared cholangiography. J Gastrointest Surg. 2012 Sep;16(9):1814-5.
14. Battacharya R. Cholecystectomy in west port, New Zealand. Indian journal of surgery, August 1983; 450-455.
15. AP Tamahankar. The fate of gall stones: Traditional practice questioned. Ann RCollSurgEngl 2003; 85: 102- 104.
16. Maj. Alok Sharma. Towards a safer cholecystectomy - the fundus to porta approach. Indian journal of surgery. 1997; 141-145.
17. Ganey J B. Cholecystectomy: Clinical experience with a large series. Am J Surg 1986; 352-357.
18. Goswitz J T. Bacteria and biliary tract disease. Am J Surg. 1974; 128: 644.
Katari A,Ramu M. A Clinical Study on Laparoscopic Cholecystectomy in a Tertiary Care Teaching Hospital. Perspectives in Medical Research 2021; 9 (2):15-18 DOI:10.47799/pimr.0902.04