EARLY CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: EXPERIENCE AT DHQ HOSPITAL ABBOTTABAD

Asif Saeed, Muhammad Nawaz, Aysha Noreen, Sarfraz Ahmad

Abstract


Background: Cholelithiasis is a common disorder affecting the females more commonly. Most of the
population carrying the gallstones remains asymptomatic, however biliary colic and acute cholecystitis
is a common complication. Most surgeons agree that early cholecystectomy is safe and should be the
procedure of choice in acute cholecystitis. Objective of this study was to determine the frequency of
patients with acute cholecystitis, and morbidity and mortality in such cases. Methods: A prospective
study, conducted at DHQ Hospital Abbottabad, and Yahya Welfare Hospital, Haripur simultaneously
on 162 patients having symptomatic gall stones. All patients were admitted on presentation and surgical
intervention done within 72 hours on patients fit for surgery. Patients with cardiac problem, HCV
positive, and with radiologic evidence of Common Bile Duct (CBD) stones were excluded.
Ultrasonography abdomen was the main investigation. Results: Postoperative complications, hospital
stay and return to routine activities was evaluated. The postoperative complications were seroma
formation in 3 cases (1.9%), liver trauma resulting in bleeding and prolonged hospital stay in 1 case
(0.6%). In 1 patient stones slipped into CBD resulting in CBD exploration. Conclusions: Early
cholecystectomy with upper right transverse incision and muscle retraction in acute cholecystitis is a
safe, and cost effective procedure with fewer complications, better cosmesis and early return to work.
Keywords: Gall stones, Cholecystitis, Bile leakage, CBD stones, Cholecystectomy

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