Objective: To analyze the effects of low and standard intra-abdominal pressure on post-operative pain in laparoscopic cholecystectomy. Study Design: Comparative prospective study. Place and Duration of the Study: Department of General Surgery, Pak Emirates Military Hospital Rawalpindi, from Nov 2019 to Feb 2020. Methodology: The study comprised 53 patients who underwent Laparoscopic Cholecystectomy and were selected for the study. They were randomly divided into two groups by third-party randomization. The first group was operated on under low pneumatic pressure, i.e. 8-12 mmHg and the second group was operated on under high pneumatic pressure, i.e. (≥15 mmHg). The complaint of post-operative pain was evaluated using a visual analogue scale (VAS) in the next 12 hours. Results: The group that was operated under high pneumatic pressure showed a higher occurrence of post-operative pain (50.9%) than the group that operated under low pneumatic pressure. On the Visual Analogue Scale, 80.0% of patients with high pneumatic pressure showed a pain of score four or more which is very high compared to the other group (p <0.05). Conclusion: The patients operated for laparoscopic cholecystectomy under low-pressure pneumoperitoneum would suffer from less post-operative abdominal pain, which needs less analgesia and leads to early hospital discharge.

Objective: To observe the effects of topical Gentamycin as a prophylactic measure to control post-operative port site infection after bile spillage during gall bladder retrieval in patients undergoing laparoscopic cholecystectomy. Study Design: Quasi-experimental study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi, from Feb to Aug 2019. Methodology: The study population comprised 80 patients (divided into two groups) diagnosed with cholelithiasis and underwent elective laparoscopic cholecystectomy. Seven surgeries were converted into open cholecystectomies, and bile spillage was recorded in 42 patients who underwent uneventful surgery. These patients were then examined for 30 days to evaluate port site infection. Results: It was seen that EPSI was more common in patients in the fourth decade of their life even after Gentamicin prophylaxis 6 (14.29%). A deeper analysis of the study showed that EPSI was more common in patients with Class-I obesity and their fourth decade of life. When compared to the gender, we found that the ratio of EPSI was higher in the female population (1:2) as compared to males (1:4). Conclusion: In our research, topical use of Gentamicin in potentially contaminated laparoscopic cholecystectomy after bile spillage during gall bladder retrieval proved beneficial.