Port site Infection in laparoscopic cholecystectomy in a teriary care hospital – a retrospective study

Arif Salam Khan,Md Ibrahim Siddique,Mohammad Faroque Eastiak,Shishir Sikto Sarker,Ferdous Alam,Md Sarower Islam

doi:10.3329/bsmmuj.v14i4.56606

Arif Salam Khan, Md Ibrahim Siddique + Show 4 more

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https://doi.org/10.3329/bsmmuj.v14i4.56606

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Abstract

Port site infection(PSI) in laparoscopic surgery is not very uncommon. The main aim of this study was to assess the causes of port site infection and its management. This retrospective descriptive study was conducted on 48 patients from March 2019 to December 2020 who develop port site infection after laparoscopic cholecystectomies. Operation notes were analyzed; and swabs were taken for culture & sensitivity. Exploration and wound debride- ment with excisional biopsies were done under local anesthesia for all patients. All patients were followed-up for one year postoperatively. Factors as gender, site of infected port, types of microorganism, acute versus chronic cholecystitis, type of infection (superficial or deep infection) and intraoperative spillage of stones, bile or pus were analyzed . Age of the patients ranged from 15 years to 60 years and the mean age was 32.4 years. The female to male ratio is 2.2:1. Among the subjects, 56.25% patients suffered from acute and 43.75% suffered from chronic cholecystitis. 35.42% had a history of spillage of bile or stones in the abdomen. Considering the site of infection, 33.33% had only umbilical port site infection, 18.75% had only epigastric port infection and 47.92% had multiple port infection. 58.33% suffered from superficial infection and others had deep site infections. Histopathology reports showed granulomatous infection in case of 37.5% patients. So, special consideration should be taken in chronic deep surgical site infection as Mycobacterium tuberculosis could be the cause. BSMMU J 2021; 14(4): 99-103

Highlights

3) Organ/space SSI where infection involves any organ and spaces other than the incision which was opened or manipulated during surgery.[9-12]. In this retrospective descriptive qualitative study, 48 patients were taken into account who came from different parts of the country with PSI following laparoscopic cholecystectomy during the period of 1st March 2019 to 31st December 2020
Total 48 patients who developed PSI following laparoscopic surgery were included in our study
The female to male ratio is 2.2:1. (Table-I) Among 48 patientsincluded in this study, 27(56.25%) patients suffered from Acute cholecystitis and 21(43.75%) patients suffered from chronic cholecystitis. (Table-II)

Summary

Introduction

Laparoscopic techniques have revolutionized the field of surgery. Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gallstones[1]. The rapid advancement in charged-coupled device (CCD) cameras and the flexible light sources have made laparoscopic surgery more affordable and widely available. The use of laparoscopy has expanded to more sophisticated surgeries as well as the management of malignancies.[3]. The laparoscopic cholecystectomy is still not free of complications. Traumatic injuries related to access and manipulation of laparoscopic instruments, diathermy injuries due to coupling, inadvertent contact with viscera resulting in heat-related injuries, hepatobiliary injuries due to improper traction, unsuitable application of clips and energy sources and port-related complications like infection, metastasis, bleeding, hypertrophic scar and incisional hernia are the few crucial issues.[4,5]

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