Background: The laparoscopic surgery technique has rapidly spread because of its several advantages over conventional open surgery. The diminishment of postoperative pain provided positive human impact, and the reduction of length of hospital stay as well as the earlier return to work generated a positive socioeconomic impact. However, despite being minimal invasive this surgical method, postoperative complication cannot be disregarded.
Objective: To evaluate the complications of laparoscopic cholecystectomy in symptomatic and asymptomatic cholelithiasis.
Methodology: 364 & 387 patients of laparoscopic cholecystectomy in BIRDEM General Hospital, Dhaka, Bangladesh and Khulna Medical College Hospital, Bangladesh were included in this prospective study on the basis of convenient purposive sampling from a period of 30.06.14 to 30.09.16 & 01.01.11 to 30.09.16 respectively.
Result: Results of this study suggests that among the patients of BIRDEM, 25.5% cases were male and 74.5% patients were female. Mean±SD of age were 43±1.4 and 42±1.7 respectively. On the other hand, among the KMCH patients, 26.1% were male and 73.9% were female. Mean±SD of age were 46±1.3 and 43±1.9 respectively. Among the total 364 cases in BIRDEM, in case of 277 (76.1% approximately), laparoscopic cholecystectomy was done due to chronic cholecystitis whereas in case of KMCH it was 83.2%. Post cholecystectomy syndrome was found to be the most frequent complications which was recorded 4.7% in BIRDEM and 7.5% in KMCH followed by port site bleeding, 3.8% and 4.4% respectively. The prevalence rates of vascular, hepatic bed haemorrhage were 2.5% & 2.5% respectively in BIRDEM and 2.8% & 3.4% in KMCH. Open conversion rates were 5.2% in BIRDEM and in 7.0% in KMCH. The overall mortality was approximately 1.1% & 2.3% respectively. The prevalence of spilled stone, biliary leakage, bowel injury, port site infection, surgical emphysema were 1.6%, 1.9%, 1.1%, 3.0% & 0.8% respectively in BIRDEM and 1.8%, 2.3%, 1.8%, 4.9% & 0.5% respectively in KMCH.
Conclusion: Laparoscopic cholecystectomy is a safe and effective procedure in almost all patients with cholelithiasis. Proper preoperative work up, awareness of possible complications and adequate training makes this operation a safe procedure with favorable result and lesser complications.
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Published on: May 22, 2017 Pages: 33-36
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DOI: 10.17352/2455-2283.000035
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