Online ISSN: 2515-8260

Keywords : Cholelithiasis


Factors predicting the operative difficulty in Laparoscopic cholecystectomy: An observational study

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 6104-6111

Background: Laparoscopic cholecystectomy is minimally invasive surgery done for removal of diseased gall bladder and considered as gold standard. It is the commonest general surgical procedures done worldwide.
Methodology: An observational study done in Hind Institute of medical Sciences, Barabanki. from June 2017 to June 2021 during which patients admitted with the plan of laparoscopic cholecystectomy were preoperatively evaluated clinically, biochemically and radiologically. LC was performed by standard 4 port technique was under GA by qualified surgeon and well-trained team. Surgery was categorised into easy, difficult and very difficult depending on the duration of surgery. Preoperative factors were then analysed and compared with the operative difficulty.

Factors predicting the operative difficulty in Laparoscopic cholecystectomy: An observational study.

Hemant Kumar Gupta, Vijay Kumar Goel, Neharika

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9954-9961

Background: Laparoscopic cholecystectomy is minimally invasive surgery done for
removal of diseased gall bladder and considered as gold standard. It is the commonest
general surgical procedures done worldwide.
Methodology: An observational study done in Hind Institute of medical Sciences,
Barabanki. from June 2017 to June 2021 during which patients admitted with the plan
of laparoscopic cholecystectomy were preoperatively evaluated clinically, biochemically
and radiologically. LC was performed by standard 4 port technique was under GA by
qualified surgeon and well-trained team. Surgery was categorised into easy, difficult
and very difficult depending on the duration of surgery. Preoperative factors were then
analysed and compared with the operative difficulty.
Result: A total of 300 patient underwent LC in which 71.7% were females. Mean age of
patients was 41.36±13.68 years with 31.3% patients between 41-49 years. Recurrent
abdominal pain was observed in 38.3% and 4.3% patient had history of biliary
pancreatitis. Ultrasonologically, single stone was observed in 62% whereas thickened
GB wall was observed in 33%. Serum ALP was elevated in 2.3 % whereas 2.7% had
leucocytosis. Operative ease was encountered in 40% consuming < 60 minutes, whereas
56.7% was difficult (60-120 mins) and 3.3 % were very difficult (>120 mins).
Conversion rate was 1.65%, all from very difficult category. Age 40-49 years, solitary
GB calculus, GB wall thickness > 4mm, leucocytosis and history of pancreatitis has
statistically significant correlation with difficult cholecystectomy but no such association
was observed with gender, elevated serum ALP and comorbidities.
Conclusion: Difficult LC was observed in 60% patients. Age between 41-50 years,
solitary GB calculus and thickened GB wall (>4mm) with a attack of pancreatitis can be
considered as predictor for difficult cholecystectomy.

Clinical profile of patients treated with cholecystectomy at a tertiary care hospital

Dr.SadiqHusainKachavi, Dr.CG Sunil, Dr.Sandeep Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 428-432

Gallstones are composed predominantly of cholesterol, bilirubin and calcium salts with lesser amounts of other constituents. The most popular classification system uses the relative amount of cholesterol as the main criterion and designates gallstones as being either cholesterol or non-cholesterol. The latter are further classified as black or brown pigment stones. A thorough preoperative anaesthetic evaluation was done and patient fitness for general anaesthesia assessed. A dose of antibiotics (usually a cephalosporin) was given 30 minutes before surgery. A nasogastric tube was inserted routinely. The most common indication for open cholecystectomy was symptomatic cholelithiasis (68%). In the laparoscopic group also cholelithiasis (76%) was the most common cause.

Descriptive study on the clinical profile of patients with cholelithiasis

Dr. M Gururaj, Dr. J Mayur Kumar,Dr.M Lakshman Kumar Yadav, Dr.BalaMurali Krishna Mudiyam MS

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1245-1249

In India, the incidence of the disease is on the increase due to the change in diet patterns and
the greater awareness of the problems. A gallstones survey limited to railroad workers
conducted in 1966 utilizing oral cholecystography had suggested that gallbladder stones
occurred 7 times more commonly in North Indian workers than in South Indian workers.
Patients were selected according to inclusion and exclusion criteria after taking informed
consent and reassuring them keeping confidentiality of their data. In all the 200 patients,
patients diagnosed as cholelithiasis and who underwent laparoscopiccholecystectomyor
converted to open-cholecystectomywere included in the study. After explaining complete
details of the procedure and complications to the patients, the surgery was performed under
general anesthesia. In our study out of 200 patients, majority of patients, both male and
female had pain as their chief complaints with total percentage of (62%).Next to pain
majority of patients including males (10) and females (16) Nausea as major complaint
constituting (13%) of total average. Dyspepsia 21 i.e., (10.50%), pain + nausea 15 i.e.,
(7.50%) and pain + jaundice 14(7%) as their chief complaints in decreasing order.

Open cholecystectomy versus laparoscopic cholecystectomy: A comparative study at north Indian based teaching hospital

Dr. Vipin Kumar, Dr. E.D. Reddy, Dr. Chandra Shekhar, Dr. Madhu Sinha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 586-591

Background: Gallstone disease (GSD or Cholelithiasis) is a significant health problem
both worlds over (in both developing and developed nations). The main objective is
Laparoscopic cholecystectomy has rapidly become established as the popular alternative to
open cholecystectomy, but it should have a safety profile better than of open procedure.
Aims and objectives: The aim of this study was to compare conventional cholecystectomy
and laparoscopic cholecystectomy with respect to duration of procedure, complications,
postoperative pain, analgesic requirement and period of hospital stay.
Materials and Methods: This study consists of 52 patients who have undergone gallbladder
removal in GMC Budaun. 26 patients who have undergone laparoscopic cholecystectomy
and 26 patients who have undergone open cholecystectomy for a study period of one year
have been taken into the study In method 52 consecutive patients below 70 years presenting
with calculous cholecystitis with no evidence of CBD stones were randomized to undergo
open and laparoscopic cholecystectomy.
Results: 9 patients of LC and 10 patients of OC were males. Among LC 16 patients were
females and among OC group 15 were females, 28% of patients who underwent open
surgery had complications and 16% of patients who underwent laparoscopic surgery had
complications. The overall percentage of complications is lesser in laparoscopic surgery
than open surgery, The VAS was median grade 2 in LC group as compared to median
grade 4 in LC group. The NSAID’S were used for more days in OC group compared to LC
group, 23 patients who underwent laparoscopic cholecystectomy were discharged before 5
days. All patients who underwent OC stayed >5 days in hospital.
Conclusion: Herewe conclude in results, the duration of pain, rate of complications and
hospital stay were significantly lower in laparoscopic group. However the main advantages
of LC were reduced postoperative pain with less duration of analgesic intake, more rapid
recovery, reduced hospital stay and early return to normal work.