A Clinical Practice Audit of Laparoscopic Cholecystectomy at our Institute

Abstract

ABSTRACT

Background: Laparoscopic cholecystectomy has replaced open surgery in the treatment of symptomatic cholecystolithiasis.

Objective: To evaluate the clinical practices and outcome of laparoscopic cholecystectomy at our institute.

Methodology: This was a cross sectional study, conducted at Surgical Unit II, Sheikh Zayed Hospital, Rahim yar khan, from November 2018 to October 2019. Sample size: 100 patients undergoing standard laparoscopic cholecystectomy selected by non probability sampling. All the patients of laparoscopic cholecystectomy  during the study period having a clinical diagnosis of acute and chronic cholecystitis were included, whereas patients who had previously undergone midline abdominal operations, ventral hernias, with evidence of common bile duct pathology, having bleeding disorders and hepatitis were excluded. Study variables were operating time, duration of hospital stay, frequency of operative and post-operative complications.

Results: There were 85 females and 15 males. Mean age was 40 ± 1.2 years. In this study, 68% patients were having chronic cholecystitis due to cholelithiasis whereas 32% were having acute cholecystitis. Abdominal ultrasound showed multiple stones in 82% and single stone in 18% patients. Adhesions in 30%, Mucocele in 1% and empyema in 2%  patients was reported. Gall bladder was perforated in 12% patients and 8% patients converted to open procedure. The mean operative time for laparoscopic cholecystectomy was 71.2+ 2.6 minute. The post operative complications were; wound infection in 4%, shoulder pain 1%   and surgical emphysema 1%. The mean hospital stay was 1.38 days.

Conclusion: Laparoscopic Cholecystectomy proved a safe procedure in term of operative and post operative complications in our setup.