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Background: The incidences of post-operative complications are higher after laparotomy particularly in emergency.This study was aimed to evaluate and compare postoperative complications after emergency versus elective laparotomy performed at IGIMS, Patna. Methods: This comparative study was carried out at Department of General Surgery in Indira Gandhi Institute of Medical Sciences, Patna, Bihar during period of January 2019 to December 2019 All the patients who underwent laparotomy (elective or emergency) were included in the study. Demographic data about patients was collected and noted in pro forma. Patients were followed in postoperative period and any complication developed recorded. Complications compared according to nature of laparotomy whether elective or emergency. Results: A total of 350 patients underwent emergency laparotomy and 50 patients underwent elective laparotomy.128 (36.57%) patients developed complications following emergency laparotomy while 11 (22%) patients developed complication after elective laparotomy. Postoperative complications following emergency laparotomy included pyrexia (18.2%) followed by nausea and vomiting (12%), wound infection (11.4%), respiratory tract infection (6.85%), urinary tract infection (2.28%), gastrointestinal complications (3.71%), toxemia and septicaemia (8%). After elective laparotomy 20% patients showed postoperative fever, 10% patients suffered from postoperative nausea and vomiting and wound infection was noted in 4% patients. Conclusions: In comparison to elective laparotomy postoperative complications are more common in emergencylaparotomy.

Introduction: Common Bile Duct stones (CBD) are found in approximately 16% of the patients undergoing Laparoscopic cholecystectomy (LC). Till recently, the gold standard for treating CBD stones was endoscopic removal, if that failed, then open surgery. However, in the laparoscopic era, the best treatment for CBD stones is a matter of debate and it continues to evolve. The objective of the present study is to determine that laparoscopic CBD exploration (LCBDE) is a safe, feasible and single-stage option for the management of CBD stones. Materials and Methods :Out of the 2900 laparoscopic cholecystectomies we did selective intraoperative cholangiogram in 262 patients who were suspected to have CBD stones based on deranged liver function tests, dilated CBD with or without CBD stone on sonography or having the history of recent jaundice/pancreatitis. If CBD stone was found, either a transcystic or transcholedochal exploration was done depending on the size, site, number of stones and CBD diameter. Choledochotomy was closed over a t-tube in the majority of the patients. Primary closure of CBD was done in few patients and in one patient we placed an antegrade stent and in another we placed endoscopic stent into the CBD laparoscpically which was removed after four weeks. Results :Till date we have performed LCBDE in 64 patients. Transcystic exploration was done in 14 patients and transcholedochal exploration was done in 46 cases out of which 2 patients had minor biliary leak which settled on conservative treatment in 2-3 days. Four patients required conversion to open surgery as there were multiple stones. We did not have any major complication and on 6 months follow-up in 76% patients, none was found to have residual stone. Conclusion :The treatment of CBD stones depends on the resources available, technical limitations and the surgeon’s expertise. Laparoscopic CBD exploration is a safe, feasible and single-stage option for the management of CBD stones.

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Background: The objective of the study was to evaluate the advantages of USG guided pigtail catheter placement fordrainage of liver abscess as a minimally invasive procedure. Methods: This is a retrospective study conducted in Indira Gandhi Institute of Medical Sciences, Patna, Bihar fromApril 2018 to September2018It included 45 patients who were diagnosed with solitary liquefied liver abscess. The effectiveness of drainage was determined by doing serial USG scans. Results: Age group varied from 27 to 52 years. Out of 45 patients 41 were men and 4 were women. The male tofemale ratio was 10:1. All the patients underwent USG guided pigtail catheter insertion for solitary liver abscess. Average hospital stay varied from 2–3 days. No complications were observed during the procedure. Conclusions: This study concludes that drainage of solitary liver abscess by USG guided pigtail placement as aminimally invasive procedure was good in clinically improving the patient’s general condition & decreasing the size of abscess cavity.