PORT SITE TUBERCULOSIS FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY PRESENTING WITH PERSISTENT DISCHARGE

Mohan Kumar Das; Anirban Bhunia; Sweta Nandy; Debarshi Jana

Volume : IX, Issue : V, May - 2020

PORT SITE TUBERCULOSIS FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY PRESENTING WITH PERSISTENT DISCHARGE

Mohan Kumar Das, Anirban Bhunia, Sweta Nandy, Debarshi Jana

Abstract :

BACKGROUND: Laparoscopic surgery (LS) has given the surgeon the power of not only treating diseases surgically but also limiting surgical invasiveness. LS, however, has its package of unique complications. One such complication, which is preventable although, is the port site infection (PSI). The possible causes of its development include improper sterilization of instruments, use of tap water containing resistant atypical mycobacteria to clean these instruments before immersion into glutaraldehyde solution; and seeding at the port site due to gall bladder TB. OBJECTIVES: An attempt to make surgeons aware about the complications which occur due to improper sterilisation of laparoscopic instruments ending into increased morbidity of patients. METHODS: We are presenting two cases of port site infections who presented with discharging sinus from epigastric port site scar after laparoscopic cholecystectomy. In one of them whole sinus tract was excised and wound was primarily closed. RESULTS: We report the development of a draining epigastric and umbilical sinus tract following laparoscopic cholecystectomy. Despite aggressive local treatment, there was no improvement in the condition of the epigastric port site, necessitating wide excision of the sinus tract of epigastric port site. Although subcutaneous abscesses from gallstone fragments have been reported in our institution, to our knowledge this is the first report in which the subsequent development of a sinus tract required a second operative procedure for resolution. CONCLUSION: Complications can occur even in the best of hands and it is vital that these are recognised promptly and immediately addressed