Tamjeed Gul, Waheed Kamran, Uzma Andaleeb, Sana Sahar, Roohul Muqim, Muhammad Salman.
An audit of Laparoscopic Cholecystectomy in a tertiary care hospital.
Pak J Surg Jan ;29(4):236-41.

Objective: A continuous audit is required to ensure laparoscopic cholecystectomy (LC) is performed safely in the surgical community in general. Th e aim of this study was to assess the safety of laparoscopic cholecystectomy surgery performed in tertiary care hospital. Study Design: Prospective clinical practice audit. Sett ing and Duration: Surgical Department, Khyber Teaching Hospital Peshawar from 23rd March 2009 to 10th October 2011. Methodology: 1115 patients presenting with signs and symptoms suggestive of acute or chronic cholecystitis of any age group and of both gender undergoing laparoscopic cholecystectomy were included. All the data was recorded on a standardized performa. Bias and confounders in the study were controlled by strictly following the exclusion criteria. Th e data collected included patient demographics, operative fi ndings, operative time, conversion rate, length of hospital stay, wound infection and mortality. Results: 1115 patients underwent laparoscopic cholecystectomy during the study period. Th e mean age of all the patients undergoing LC was 39.82±12.3 years ranging from 12–81 years with male to female ratio of 1:6.04. Th e overall rate of conversion from laparoscopic to open cholecystectomy was 4% with dense adhesions making dissection of Calot’s triangle the commonest cause (2.3%). Bleeding was the commonest complication, occurring from trocar site in 115 (10.31%), vascular injury in the callot’s triangle in 145 (13%) and liver bed in 120 (10.76%) cases. Gall bladder perforation occurred in 275 cases with spilled gall stones in 145 (13%) cases. Injury to the common bile duct (CBD) was observed in two cases. Port site infection was observed in 36 (3.23%) cases. No mortality was observed during the study period Th e mean operative time was 43.8±9.7 minutes. 90% of the patients were discharged within 48 hours of surgery. Conclusion: Laparoscopic cholecystectomy is a safe and eff ective procedure in most of the patients with less morbidity and mortality.

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