Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

Maitra, Tapash Kumar; Ullah, Mahmud Ekram; Faruquzzaman,; Mondol, Samiran Kumar

doi:10.3329/bccj.v5i1.32536

Cited by 8 publications

(18 citation statements)

References 14 publications

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“…In our study, we encountered one patient (1.49%) who had uncontrolled haemorrhage requiring conversion and 1 patient (1.49%) had common bile duct injury requiring conversion. This was quite low in comparison to study done by Maitra et al 9 where bleeding and common bile duct injury was 11% and 4% respectively.…”

Section: Discussioncontrasting

confidence: 62%

“…We have included n=9, 13.4% patients of acute cholecystitis and n=3, 4.4% patients of chronic cholecystitis. Maitra et al 9 have also included 69.2% patients of chronic cholecystitis and 18.6% cases of acute cholecystitis. Biswas et al 10 have done a prospective study on patients of acute cholecystitis dividing them into two groups according to duration of symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Cholecystectomy; Is Conversion Really a Complication- A Prospective Study to Evaluate Complications and Conversion Rates

Sonker¹,

Jain²,

Barle³

2019

jemds

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BACKGROUND In this era of advanced surgical approaches, Laparoscopic Cholecystectomy is the procedure of choice for gall bladder diseases. But fear of conversion to open cholecystectomy is really a night mare among surgeons and patients. Good counselling and better predictability can avert the misconception of conversion as a complication of it. This study was conducted with an aim to evaluate complications as well as conversion rates in normal and high risks patients. MATERIALS AND METHODS The study included all adult subjects who have definite clinical, biochemical and radiological indications for laparoscopic cholecystectomy. After clearance from the ethical committee, we also included those patients in whom laparoscopic cholecystectomy was previously not frequently performed like acute cholecystitis, chronic cholecystitis, history of previous upper abdominal surgeries, and in obese patients with BMI>30. Definitely benefits outweigh risks in these patients. Statistical analysis was done by using chi square test, Fisher's exact test with the help of SPSS version 20. RESULTS We have observed that out of 67 subjects, n=22, 32.8% were between 31-40 years of age, n=43, 64.1% were females and n=24, 35.8% were males. Commonest complaint is abdominal pain present in n=43, 64.2%. Cholelithiasis was the most common indication present in n=52, 82% patients. Out of 67 patients, n=6, 8.9% had history of upper abdominal surgeries, acute cholecystitis present in n=9, 13.4%, chronic cholecystitis in n=3, 4.4% and n=2, 2.9% had BMI >30 kg/m 2. Total conversion rate was n=8, 11.9% which was slightly high as we have included high risk patients also. But still we have avoided conversion in total n=4, 66.6% with upper abdominal surgeries, n=2, 66.6% patients with chronic cholecystitis, n= 4,100% in acute cholecystitis of pain duration<72 hours and n=2,100% obese patients. Although p-value calculated by chi square test was found to be 0.3126 [>0.05]. CONCLUSION Definitely, conversion should never be considered as a complication of laparoscopic cholecystectomy and there is no question that laparoscopic cholecystectomy is the gold standard for gallbladder diseases.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy; Is Conversion Really a Complication- A Prospective Study to Evaluate Complications and Conversion Rates

Sonker¹,

Jain²,

Barle³

2019

jemds

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“…The incidence rates of perforation of gall bladder, stone spillage were 9.3% and 5.2% respectively. Serious complications like bowel injury and bile duct injury were recorded in 0.6% and 1.2% cases respectively (Maitra, T.K. et al, 2017).…”

Section: Outcome Of Laparoscopic Cholecystectomymentioning

confidence: 99%

“…(Coccolini, F. et al, 2015). Port site infection developed in 5.2% of laparoscopic cholecystectomy patients reported by Maitra, T.K. et al, (2017).…”

Section: Outcome Of Laparoscopic Cholecystectomymentioning

confidence: 99%

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Cost-effectiveness Analysis of Per-abdominal and Laparoscopic Cholecystectomy

S¹

2019

Preprint

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Cholelithiasis is one of the major problems which need cholecystectomy. Laparoscopic cholecystectomy is a newer technique. But there is a need to evaluate the cost-effectiveness of per-abdominal and laparoscopic method from patients perspective. The study was performed to assess the cost-effectiveness of per-abdominal and laparoscopic cholecystectomy. Materials and Methods: This cross sectional study in two sample situations was conducted among 90 purposively selected cholecystectomy patients of which 60 patients underwent laparoscopic cholecystectomy (LC) and 30 patients underwent per-abdominal cholecystectomy (PAC) from three tertiary level government hospitals of Dhaka, Bangladesh at the time of their discharge through face to face interview using a semi-structured questionnaire and checklist. The study found average age 45.33(13.63) and 41.75(13.39) years in PAC and LC respectively. Average monthly income was less in the PAC group Tk.23200.00(12374.61) than LC Tk.24925.00(12166.86). Average duration of suffering from cholelithiasis was 9.50(8.68) months in PAC group and 12.43(17.49) months in LC group. Average hospital stay was 13.97(6.88) days in PAC group while it was 12.02(6.66) days in LC group. Average treatment cost was little higher Tk.21927.407795.89 in LC group than Tk.21466.306261.42 in the PAC group. Both direct cost and indirect cost were also higher in LC group (Tk.18668.305965.67 and Tk.3661.324229.85) than in PAC group (Tk.18228.004624.75 and Tk.3350.004124.58). But these differences were not statistically significant. In both groups treatment cost significantly increased with duration of hospitalization (correlation, p<0.01). Cure rate was significantly high in LC group (94.4%) than in PAC group (86.7%) (χ2, p<0.05). This study revealed LC method is cost-effective than PAC method. Total treatment cost in LC can be reduced by minimizing hospital cost, laboratory cost and securing the income of the patients which enhance the economic load.

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Effect of implementation of operating room nursing path in patients receiving laparoscopic cholecystectomy in a tertiary hospital

Ma¹,

Chen²

2019

WCJD

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Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

Cited by 8 publications

References 14 publications

Laparoscopic Cholecystectomy; Is Conversion Really a Complication- A Prospective Study to Evaluate Complications and Conversion Rates

Laparoscopic Cholecystectomy; Is Conversion Really a Complication- A Prospective Study to Evaluate Complications and Conversion Rates

Cost-effectiveness Analysis of Per-abdominal and Laparoscopic Cholecystectomy

Effect of implementation of operating room nursing path in patients receiving laparoscopic cholecystectomy in a tertiary hospital

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