IJCRR - 8(1), January, 2016
Pages: 01-05
RETROSPECTIVE ANALYSIS OF CHOLECYSTECTOMY PERFORMED IN AN INSTITUTION FOR LOWER SOCIOECONOMIC POPULATION IN INDIA
Author: Tanweer Karim, Subhajeet Dey, Rabishankar Singh, Vivek K. Katiyar
Category: Healthcare
[Download PDF]
Abstract:
Background: Gallstones are common in Indian population.Laparoscopy requires longer and steeper learning curve and proper patient selection. Patients belonging to lower socioeconomic group usually present late, develop one or the other complications of cholelithisis prior to surgery and expected to have higher conversion rate, per-operative and post-operative complications. Aims: To study safety and efficacy of laparoscopic cholecystectomy in patients of cholelithiasis by comparing with results of open cholecystectomy in terms of use of post-operative analgesia, operative Time, post-operative hospital stay, morbidity and mortality. Material and Method: Patients operated for gallbladder stone betweenJanuary 2013 and August 2015were retrospectively analyzed in terms of demographic profile, clinical presentation, procedureperformed and its findings, operating time, conversion rate, postoperative pain and analgesic requirement, postoperative hospital stay and complication. Results: Cholecystectomy was performed in 630 patients between January 2013 and August 2015. 368 patients were operated laparoscopically and 232 patients by open method. It comprises of almost 25 percent of major operations performed during this period, 75.8% were females and 9 of them were less than 15 years of age. The mean operating time during 2013 for laparoscopic and open Cholecystectomy was 68.37 minutes and 66.20 minutes, decreased to 46.27 minute and 53.33 minute during 2014-15, respectively. Intraoperative cholangiography was not required in any case. Conclusion: Cholelithiasis is relatively common in India even in lower socio-economic group. Dietary habits and obesity do not appear as contributing factor.Laparoscopy has better visibility, access and operating time than open cholecystectomy. Complications rate is negligible even in difficult gallbladders, if proper planning is done with ultrasonography and liver function test 24 hours prior to surgery.
Keywords: Laparoscopic cholecystectomy, Open cholecystectomy, Cholelithiasis, Obstructive jaundice, Pancreatitis
Citation:
Tanweer Karim, Subhajeet Dey, Rabishankar Singh, Vivek K. Katiyar. RETROSPECTIVE ANALYSIS OF CHOLECYSTECTOMY PERFORMED IN AN INSTITUTION FOR LOWER SOCIOECONOMIC POPULATION IN INDIA International Journal of Current Research and Review. 8(1), January, 01-05
References:
1. Mouret P. From the first laparoscopic cholecystectomy to frontiers of laparoscopic surgery; the future perspective. Dig Surg. 1991;8:124–125
2. Ellis H. John Stough Bobbs: father of gall bladder surgery. British journal of hospital medicine London England 2005. 2009;70(11):650.
3. Traverso LW. Carl Langenbuch and the first cholecystectomy. [Internet]. American journal of surgery. 1976. p. 81–2.
4. Paulino-Netto A. A review of 391 selected open cholecystectomies for comparison with laparoscopic cholecystectomy. American journal of surgery. 1993; 166 (1):71–3.
5. Cheslyn-Curtis S, Russell RC. New trends in gallstone management. The British journal of surgery. 1991;78(2):143–9.
6. Villanova N, Bazzoli F, Taroni F, Frabboni R, Mazzella G, Festi D, et al. Gallstone recurrence after successful oral bile acid treatment. A 12-year follow-up study and evaluation of long-term post dissolution treatment. Gastroenterology. 1989;97(3):726– 31.
7. Escarce JJ, Chen W, Schwartz JS. Falling cholecystectomy thresholds since the introduction of laparoscopic cholecystectomy. JAMA 1996;91(20):2653–4.
8. McSherry CK, Ferstenberg H, Calhoun WF, Lahman E, Virshup M. The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients. Annals of Surgery. 1985;202(1):59–63.
9. Lam CM, Murray FE, Cuschieri A. Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy in Scotland. Gut. 1996;38(2):282–4.
10. Jani K, Rajan PS, Sendhilkumar K, Palanivelu C. Twenty years after Erich Muhe: Persisting controversies with the gold standard of laparoscopic cholecystectomy. Journal of Minimal Access Surgery; 2006;2(2):49–58. A
11. Thompson JS, Philben VJ, Hodgson PE. Operative management of incidental cholelithiasis. American journal of surgery. 1984;148(6):821–4.
12. Alponat A, Kum CK, Koh BC, Rajnakova A, Goh PM. Predictive factors for conversion of laparoscopic cholecystectomy. American journal of surgery 2002;21(3):254–8.
13. Domínguez LC, Rivera A, Bermúdez C, Herrera W. Analysis of factors for conversion of laparoscopic to open cholecystectomy: a prospective study of 703 patients with acute cholecystitis. Cirugia Espanola. 2011;89(5):300–6.
14. Barone JE, Lincer RM. Correction: A prospective analysis of 1518 laparoscopic cholecystectomies. The New England Journal of Medicine. 1991. p. 1517–8.
15. Kane RL, Lurie N, Borbas C, Morris N, Flood S, McLaughlin B, et al. The outcomes of elective laparoscopic and open cholecystectomies. Journal of the American College of Surgeons. 1995. p. 222–3.
|