Lam Rai M Aslam, Wad Aslam M Fawad, Sara Aslam.
Laparoscopic Cholecystectomy - Outcome and Complications.
J Rawal Med Coll Jan ;18(2):234-6.

Background: To evaluate success rate, complications and outcome of laparoscopic surgical approach towards symptomatic cholelithiasis. Methods: In this descriptive study ,patients(n=3100), 2780 females and 320 male, with symptomatic cholelithiasis were subjected to laparoscopic cholecystectomy. Patients having a suspected, common bile duct stone, were excluded. Standard four port technique was adopted, after creating pneumoperitonium through Veress needle. Umbilical port was introduced for laparoscope,one epigastric port both 1 cm and 2 ports in right hypochondrium of 5 mm for instrumentation. Calots triangle was dissected with help of spatula and Maryland forceps.Cystic duct and artery were dissected and isolated, clipped, 2 on proximal side and one distally.Laparoscopic scissor was used to cut between and then gallbladder was dissected from its bed. Gallbladder was extracted through epigastric port. Results: In majority(99.61 %) it was successful, while 0.39% required open conversion. Two patients for primary haemorrhage, slip of cystic artery in 1st 15 cholecystectomies. Ten patients had very dense adhesions. Age variation was from 16 years to 90 years. Females were 72.80%. There was no mortality. Minor wound infection was seen in 0.96%. Majority (72.83%) were retained for 48 hours. Complications were seen in 1.06%. Conclusion: Laparoscopic cholecystectomy has safely replaced open surgery. After proper selection open conversion is not usually required.

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