DOI: https://doi.org/10.

53350/pjmhs211582477
ORIGINAL ARTICLE

Complications of Laproscopic Cholecystectomy in Patients of Acute

Cholecystitis
HASEENA REHMAN1, GUL LALLEY2, GULSHARIF3, ASIM SHAFI4, ASIF MEHMOOD5, MOHAMMAD SHOAIB KHAN6
1
Medical Officer General Surgery, Muhammad Teaching Hospital, Peshawar
2
Medical Officer General Surgery, Mian Rashid Hussain Shaheed Memorial hospital, Nowshehra.
3
Assistant Professor, General Surgery, MTI Lady Reading hospital, Peshawar
4
Associate Professor General Surgery, Bakhtawar Amin Medical & Dental College, Multan.
5
Assistant Professor, General Surgery, Khalifa Gul Nawaz Teaching Hospital, Bannu
6
Assistant Professor General Surgery Khalifa Gul Nawaz Medical Teaching Institute, Bannu
Corresponding Author: Dr Gulsharif, Email: [email protected], Cell No: +92 300 5959004

ABSTRACT
Objective: To determine the complications of laparoscopic cholecystectomy in patients of acute cholecystitis.
Study Design: Prospective study.
Place & Duration: Department of Surgery, Lady Reading Hospital, Peshawar for duration of six months from
January 2020 to June 2020.
Methods: Total 120 patients of both genders with ages 20 to 60 years were included in this study. Patients’
detailed demographics were recorded after taking written consent. Patients with history of abdominal surgery
were excluded. All the patients underwent laparoscopic cholecystectomy for gall bladder diseases. Post-operative
pain was analyzed by VAS. Complications were recorded at 5th postoperative day. Data was analyzed by SPSS
24.0.
Results: Out of 120 patients 30 (25%) patients were males and 75% patients were females. Most of the patients
50 (41.67%) were in the age group 31 to 40 years followed by 37 (30.83%) patients were ages between 41 to 50
years. 70 (58.33%) patients had surgical size port incision was 5mm and 50 (41.67%) patients had 10mm. Mean
pain score was 2.24+1.1 at 5th postoperative day. Wound infection was found in 10 (8.33%). Port site hernia was
found in 12 (10%).
Conclusion: Laparoscopic cholecystectomy is safe and effective treatment procedure with no major
complications.
Keywords: Laparoscopic Cholecystectomy, Acute Cholecystitis, Wound Infection, Port Site Hernia, Pain

INTRODUCTION MATERIALS AND METHODS

In the present day, the standard treatment for symptomatic This study was conducted at Department of Surgery, Lady
gallbladder stones is a laparoscopic cholecystectomy (LC) Reading Hospital, Peshawar for duration of six months
with four ports. To avoid scarring, the laparoscopic from January 2020 to June 2020. A total of 120 patients of
cholecystectomy (MLC) using an umbilical port has been both genders with ages 20 to 60 years were included in this
shown to be a minimally invasive technique for managing study. Following written consent, the detailed
and treating benign gallbladder disease. With MLC, demographics of the patients, including their age and
patients can return to daily activities sooner, feel better, gender, were recorded. Major abdominal surgeries,
and have less pain after surgery [2-3]. Patients with jaundice, acute cholecytitis, patients requiring conversion to
advanced age, cirrhosis, or medical contraindications to open surgery, and patients who did not provide written
open surgery can now benefit from MLC [4]. MLC is now a consent were all removed from consideration.
more common treatment for cholecystitis and is simple to Each patient received laparoscopic cholecystectomy
perform [5-6]. To reduce the risk of complications, careful for gall bladder disease, which was performed in all cases.
monitoring at each stage of the procedure, using The pain experienced after surgery was measured using a
standardised surgical and medical measures, as well as visual analogue scale (VAS). A total of five complications
adequate skills, is required [7]. Inflammation, adhesions of were reported on the fifth postoperative day. The final
the normal anatomy make it difficult to find the "critical view follow-up was performed three months after the surgery to
of safety" (CVS) and locate the cystic duct and cystic determine the occurrence of port-site hernia.
artery, increasing the risk of complications [8]. Data was analyzed by SPSS 24.0. Mean+SD was
However, there are still chances of bleeding due to applied. Frequencies and percentages were recorded in
inflamed and friable tissues, making bile leakage and tabulation form.
difficulty removing spilled stones more common [9]. The
risks of performing LC must be weighed against any RESULTS
potential benefits on a subjective basis. ERCP with stenting Out of 120 patients 30 (25%) patients were males and 75%
may be required if the patient's biliary drainage persists patients were females. Most of the patients 50 (41.67%)
[10]. To reduce operating time and post-operative were in the age group 31 to 40 years followed by 37
complications, laparoscopic cholecystectomy was found to (30.83%) patients were ages between 41 to 50 years, 20
be the best option by Tamura et al. (16.67%) patients had ages between 20 to 30 years and 13
The purpose of this research was to look into the risks (10.83%) were ages above 50 years. 70 (58.33%) patients
and complications associated with laparoscopic had surgical size port incision was 5mm and 50 (41.67%)
cholecystectomy and the diameter of the umbilical port. patients had 10mm. (Table 1)

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 Haseena Rehman, Gul Lalley, Gulsharif et al

Table No 1. Baseline characteristics of all the patients with 75 percent being female and 25 percent being male.
Characteristics Frequency No. Percentage The majority of patients (50/41.67%) were between the
Sex ages of 31 and 40, followed by 37 (30.83%) patients who
Male 30 25 were between the ages of 41 and 50, 20 (16.67%) patients
Female 90 75 who were between the ages of 20 and 30 years, and 13
Age (10.18%) patients who were beyond the age of 50 years.
20 to 30 yrs 20 16.67 Similar to other research [16-17], the data showed that
31 to 40 yrs 50 41.67
female patients accounted for 70 to 88 percent of all
41 to 50 yrs 37 30.83
patients, whereas male patients were primarily aged 35 to
Above 50 yrs 13 10.83
Umbilical port site diameter 60.
5mm 70 58.33 At the fifth postoperative day, we found a pain score
10mm 50 41.67 of 2.24±1.1 in our research. In 10 of the patients, wound
Mean pain score was 2.24+1.1 at 5th postoperative day. infection was found in (8.33 %). In a study by F Usmani et
Wound infection was found in 10 (8.33%). (Table 2) al [18], the mean pain score was found to be 4.7±2.62
following laparoscopic cholecystectomy. Postoperative
Table No 2. Pain score and wound infection according to wound infection rates vary from 5 to 20 percent in other
umbilical port site diameter studies [19-20]. These findings are consistent.
Variables Frequency No. P-value In this investigation, Twelve (10%) patients had a
Mean Pain score 2.24+1.1 - hernia at the port site, but 108 (90%) had none by the time
Wound infection of the last checkup. According to these findings, individuals
Yes 10 8.33 who underwent major surgery and had incisions larger than
No 110 91.67 5mm were at an increased risk of developing a hernia at
Port site hernia was found in 12 (10%) while 108 (90%) the surgical site [21-22].
patients had not developed at final follow up. Compared to an open cholecystectomy, laparoscopic
cholecystectomy causes less postoperative pain,
Figure No 1. Frequency of port site hernia at final follow up necessitates less postoperative analgesics, requires less
time in the hospital, and allows patients to return to normal
Port Site Hernia activity in one week [23]. Also, compared to open
cholecystectomy, laparoscopic cholecystectomy improves
cosmesis and patient satisfaction.
12 (10%) CONCLUSION
In recent years, laparoscopic cholecystectomy has become
a widely used surgical procedure because of its
effectiveness and safety. We came to the conclusion that
laparoscopic cholecystectomy is a safe and effective
108 Yes therapy method with no significant side effects or risks.
(90%)
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