English

Abstract

INTRODUCTION: This study has been carried out with an objective to study the outcome of the intra operative findings in terms of post operative complications and patient recovery from laparoscopic cholecystectomy. MATERIALS AND METHODS: Sixty patients operated for laparoscopic cholecystectomy were studied prospectively. The parameters studied were age and sex of the patients, operative time, hospital stay, return to normal activity, intraoperative findings and complications. RESULT: The intraoperative findings related to gall bladder pathology were - edematous thick walled gall bladder 2 (3.3%), empyema 2 (3.3%), sessile gall bladder 1 (1.6%), contracted fibrotic gall bladder 6 (10%), mucocele 1 (1.6%), chronic cholecystitis with dense fibrotic adhesions in calot's triangle 5 (8.3%), anomalous cystic artery (Moynihan's hump) 1 (1.6%), stone impacted at neck 6 (10%), chronic cholecystitis with minor adhesions in calot's triangle 27 (45%), adhesions of gall bladder with omentum or surrounding structures 9 (15%). Average operative time was 49.2 minutes in the present study. Two cases were converted to open cholecystectomy. The conversion rate to open cholecystectomy was low (3.3%). Intraoperative complications occurred in 4 (6.66%) patients. Spillage of stone and bile was present in 3 (5%) postoperative complications occurred in 7 (11.6%) patients. Wound infection was present in 1 patient, shoulder pain in 5 patients, prolonged ileus in 1 patient. The mean postoperative hospital stay of the patients of the present study was 2.26 days (range 1 - 5.5 days) and 2.22 in uncomplicated cases. Average time for return to normal activity was 10.56 days (range 7-16 days). CONCLUSION: Our study summarizes a varied range of intraoperative findings during laparoscopic cholecystectomy which in turn helped us to assess the expected and practical outcome of surgery.