COMPARISON OF OPERATIVE TIME AND LENGTH OF HOSPITAL STAY IN LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE VERSES CHRONIC CHOLECYSTITIS

Shireen A.A Ramzanali Damani, Sadiqa Haider, Hazrat Bilal, Sughra Perveen

Abstract


Background: The laparoscopic surgery has opened a new era in the field of surgery. Currently, it is accepted as the “gold standard” in the treatment of symptomatic cholelithiasis. However, laparoscopic cholecystectomy (LC) performed for acute cholecystitis is technically difficult because of severe inflammatory adhesions and distortion of the biliary anatomy. The objective of this study was to compare the frequency, mean operative time and length of hospital stay in patients of acute and chronic cholecystitis undergoing laparoscopic cholecystectomy. Methods: This prospective comparative study was carried out in the department of General Surgery Jinnah Postgraduate Medical Centre (JPMC) Karachi, from March to September 2013. During this period 233 patients underwent laparoscopic cholecystectomy (54 cases of acute and 179 cases of chronic cholecystitis respectively). The patients who were pregnant, diagnosed with gall bladder mass on ultrasound, carcinoma gall bladder, acute pancreatitis, and those with co-morbid like diabetes mellitus/cardiovascular disorders were excluded. Result: A total of 233 patients were admitted for laparoscopic cholecystectomy. Fifty four (54) patients in Group A (acute cholecystitis) and 179 patients in Group B (chronic cholecystitis) with female: male 2.8:1 and 4:1 in Group A and B respectively. Operative time was longer for group A. Six cases of conversion to open procedure one (1) in Group A and 5 in Group B respectively. Conclusion: Laparoscopic cholecystectomy is safe and efficient for both acute and chronic cholecystitis.

Keywords: Laparoscopic cholecystectomy, acute cholecystitis, chronic cholecystitis

Full Text:

PDF

References


Rosen M, Ponsky J. Minimally invasive surgery. Endoscopy 2001;33:358–66.

Vecchio R, McFayden BV, Palazoo F. History of laparoscopic surgery. Panminerva Med 2000;42(1):87–90.

Shaheed A, Sakar M, Ibrahim KM, Habib M. Early cholecystectomy for acute cholecystitis . KMJ 2004; 36(4):281–4.

Pessaux P, Tuech JJ, Rouge C, Duplessis R, Cervi C, Araund JP. Laparoscopic cholecystectomy in acute cholecystitis. A prospective comparative study in patients with acute vs. chronic cholecystitis Surg Endosc 2000;14(4):358–61.

Sharp KW. Acute cholecystitis . Surg Clin North Am. 1998; 68:269–70

Saeed T, Iqbal J, Saeed S, Shahana S, Wazir A. Laparoscopic Cholecystectomy in acute vs. chronic cholecystitis. At department of surgery Khyber Teaching Hospital, Khyber Medical University Peshawar. Pak J Surg 2009:25(1)14–7.

Catnani M, Modini C. Laparoscopic cholecystectomy in acute cholecystitis: a proposal of safe and effective technique. Hepatogastroenterology. 2007;54(80):2186–91

Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg 2003;7(5):642–5.

Kolla SB, Aggarwal S, Kumar A, Kumar R, Chumber S, Parshad R, et al. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a prospective randomized trial. Surg Endosc 2004;18(9):1323–7.

Slater K, Strong RW, Wall DR, Lynch SV. Iatrogenic bile duct injury: the scourge of laparoscopic cholecystectomy. ANZ J Surg 2002;72(2):83–8.

Tzovaras G, Zacharoulis D, Liakou P, Theodoropoulos T, Paroutoglou G, Hatzitheofilou C. Timing of laparoscopic cholecystectomy for acute cholecystitis: A prospective non randomized study. World J Gastroenterol 2006;12(34):5528–31.

Kim JH, Kim JW, Jeong IH, Choi TY, Yoo BM, Kim JH, et al. Surgical Outcomes of Laparoscopic Cholecystectomy for Severe Acute Cholecystitis. J Gastrointest Surg 2008;12(5):829–35.

Al-Salamah SM. Outcome of laparoscopic cholecystectomy in acute cholecystitis. J Coll Physicians Surg Pak 2005;15(7):400–3.

Glavic Z, Begic L, Simlesa D, Rukavina A. treatment of acute cholecystitis. A comparison of open vs laparoscopic cholecystectomy. Surg Endosc 2001;15(4):398–401.

Suter M, Meyer A. A 10 years experience with the use of laparoscopic cholecystectomy for acute cholecystitis: is it safe?. Surg Endosc 2001;15(10):1187–92.

Navez B, Mutter D, Russier Y, Vix M, Jamali F, Lipski D, et al. safety of laparoscopic approach for acute cholecystitis: retrospective study of 609 cases. World J Surg 2001;25(10):1352–6.

Bass EB, Pitt HA, Lillemoe KD. Cost-effectiveness of laparoscopic cholecystectomy versus open cholecystectomy. Am J Surg 1993;165(4):466–71.

Fried GM, Barkun JS, Sigman HH, Joseph L, Clas D, Garzon J, et al. Factors determine conversion to laparotomy in patients Undergoing laparoscopic cholecystectomy. Am J Surg 1994; 167(1):35–9.

Johansson M, Thune A, Bllomqvist A, Nelvim L, Lundell L. Management of acute cholecystitis in the laparoscopic era: results by prospective randomized clinical trial. J Gastrointest Surg 2003;7(5):642–5.

Loo KP, Thirlby RC. Laparoscopic cholecystectomy in acute cholecystitis. Arch Surg 1996;131(5):540–4.

Svanvik J. Laparoscopic cholecystectomy for acute cholecystitis. Eur J Surg 2000;585:16–7.

Khattab OS. Outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis. J Fac Med Baghdad 2010; 52(3):263–5.


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]