Volume : VIII, Issue : XII, December - 2018

LAPROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS

Dr. Amit Kumar Mishra, Dr. S. C Sharma, Dr. S. P. Sinha

Abstract :

 Introduction:–  Acute cholecystitis is a inflammation of G.B. mostly because of blockade of cystic duct due to Gallstones.

L.C. has been gold standard T/t in modern era of minimal invasive surgery,. But debate still exist about its timings, experience of operating surgeon, conversion rate etc., but analyzing the outcome such difficulties can be accepted while advantages been same as an elective and  delayed cholecystectomy.

A Prospective study was conducted on the subject in T.M.M.C. & R.C. in the department of Surgery from June 2017 to may 2018.

Object:– The purpose of study is  to present & share our experience of operating 86 cases of Acute cholecystitis, about its safety, effectiveness whether should be attempted or not & difficulties faced & rate of conversion.

Material & Method:–  In this prospective study, L.C. on 86 pt. of acute cholecystitis was done, 143 cases out of 1548 cases of cholecystitis were diagnosed as cases of acute cholecystitis & only 86 were found to be fit to be operated in acute phase, rest were excluded because of comorbidities.

Result:–  We analyzed the results & our observation during surgery was the presence of Phlegmon, soft and flimsy  adhesions around stomach & duodenum, very fragile nature of soft tissues, difficult to hold thickened G.B. & in 9 cases its perforation  due to gangrenous wall. Our conversion rate was due to various above mentioned reasons, operation  time was prolonged (55–126mim.). Post–operative hospital stay was almost the same, oozing from the liver bed & soft tissue was a common & distressing problem, it was controlled by simple pressure technique, but drain tube had to be kept longer in majority of pt.

Discussion:– Open/Lap cholecystectomy  have been debatable since long time  but main  debate nowadays is about the timing of surgery. Many series suggest that 72 hrs. Is the golden period since the onset of symptoms &sings. Should lee safe in this period but still researches & experiences of many more is needed, but one fact still remains that the conversion rate is higher in acute cases as compare to delayed cases.

Conclusion:–Lap. Cholecystectomy in acute cases in our experience should be attempted keeping in mind about the time elapsed after symptoms, experience of surgeon, possibility to convert, longer duration of surgery & other Co– morbid conditions

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

LAPROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS , Dr. Amit Kumar Mishra, Dr. S.C Sharma, Dr.S. P. Sinha, INDIAN JOURNAL OF APPLIED RESEARCH : Volume-8|Issue-12| December-2018

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