COMPARISON OF BILIARY LEAKAGE IN LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18
Abstract
BACKGROUND Laparoscopic surgery is unsafe and technically impossible in case a gall-bladder disease has changed the usual anatomic landmarks. Though, open cholecystectomy has fewer incidents of biliary leakage, the risk cannot be avoided. However, it seems that with adoption of preventive measures and requisite skills, the biliary leakage rate has been controlled in laparoscopic surgery. The study aimed to compare the frequency and cause of biliary leak between laparoscopic (LC) and open cholecystectomy (OC). MATERIALS AND METHODS A prospective observational study carried out in Department of Surgery, Era’s Lucknow Medical College and Hospital, Lucknow from January 2016 to June 2017 (18 months). Out of 220 patients, 140 were subjected to LC and 80 to OC. Intra- and postoperative findings were analysed and the patients were followed up for 3 months. RESULTS Mean age of patients of OC (43.88 ± 12.26 years) was higher than LC (38.93 ± 12.37 years). Majority of patients (75.00%) were females. Mean duration of hospital stay among patients of OC (3.36 ± 2.80 days) was higher as compared to LC (2.53 ± 1.31 days) (p= 0.009). All cases of biliary leak were peripheral in nature, managed conservatively and did not develop peritonitis/ sepsis. Amount of drainage in OC was higher than LC on Day 1 P.O. (45.95 ± 16.35 vs. 27.95 ± 14.07 mL) and on Day 2 (26.41 ± 13.71 vs. 17.83 ± 11.69 mL). Haematological assessment showed a generalised increase in TLC and polymorph count and low lymphocyte count. Bile leak was observed in 5 (3.7%) cases of LC as compared to 2 (2.5%) cases of OC. CONCLUSION The incidence of bile leak in both categories was comparable and in agreement with the reported literature. Although, the cause of bile leak was primarily visualisation in both the groups; however, necrosis and ischaemia were suggestive of gangrenous cholecystitis also posed risk of bile leak.
Authors and Affiliations
Shadab Asif, Satendra Pratap Singh Yadav, Saleem Tahir, Ateev Ashok Singh, Saurabh Rai, Anurag Singh, Saboor Mateen
Keywords
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- EP ID EP418120
- DOI 10.14260/jemds/2018/511
- Views 77
- Downloads 0
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