LAPAROSCOPIC CHOLECYSTECTOMY: AN EXPERIENCE AT LADY READING HOSPITAL, PESHAWAR
AbstractBackground: Laparoscopic Cholecystectomy originally a minimal invasive surgical techniqueinvolving less hospital stay less economical burden decreased post op complication and early mobility.The objective was to analyse data of patients undergoing laparoscopic cholecystectomy at a surgicalsetup. Methods: This study was conducted at the Department of Surgery, Lady Reading Hospital,Peshawar from 11th January 2006 till 10th January 2009. Patients aged above 14 year, presenting in theoutpatient department with clinical and ultrasonographic evidence of cholecystitis and undergoinglaparoscopic cholecystectomy were included in the study. The procedure performed was predominantlythe four port technique for laparoscopic cholecystectomy. A proforma was prepared to collectpreoperative, operative, and postoperative data. Operative data included the technique used and thedifficulties ascertained during those procedures. Data was analysed using SPSS-13.0. Results: Of 421patients, 387 patients fulfilled the criteria for admission to undergo the procedure. The mean age of allpatients was 38.6±7.1 year ranging from 16 years to 72 year with a male to female ratio of 1:8.09.During the first six months 57 patients underwent the procedure for which the mean operating time was67.4 min. During the last six months the mean operating time was 39.1±8.9 minutes. The overall rate ofconversion of laparoscopic cholecystectomy was 6.4%. In comparison the last six months of the studyshowed one case (1.16%) in 86 patients being converted to open cholecystectomy. The most commoncause foe conversion of the laparoscopic procedure to an open cholecystectomy was dense adhesionsmaking dissection of the triangle of Calot’s difficult. In 73 cases (21.4%) the gall bladder wasperforated during dissection of gall bladder from the gall bladder bed. Conclusion: The out comes ofthis study during the last six months is comparable to studies conducted at more experienced centresmaking laparoscopic more than just an early experience in this part of the world.Keywords: Laparoscopic, Cholecystectomy, Complications, Cholecystitis
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