“Clinico-morphoradiological factors predicting Difficult Laparoscopic Cholecystectomy in viral marker positive and negative patients-A Hospital Based Comparative Study”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
At times Laparoscopic Cholecystectomy becomes difficult. Laparoscopic Cholecystectomy may be rendered difficult by various problems encountered during surgery. Aims and Objective: To study preoperatively, the Clinical, biochemical and radiological parameters in predicting difficult laparoscopic cholecystectomy. Material and Methods:This prospective study was conducted on patients of Gallbladder stone disease in the Department of General Surgery of subharti medical college admitted through surgery OPD and emergency or transferred from other department after taking informed consent and clearance from University Ethical Committee on 200 patients out of which 90 are viral marker positive and 110 are viral marker negative. Finally 84 positive and 90 viral negative patients satisfying the inclusion criteria were included in the study (n=174). Patients with Acute (within 72 hours operated) & Chronic Cholecystitis with Cholelithiasis underwent laparoscopic cholecystectomy or conversion to open approach were studied during September 2015 to July 2017 (n = 174, Laparoscopic cholecystectomy = 164 and Open conversion = 10). Statistical analysis: Univariate analysis was performed using Chi-Square test to determine the factors that are associated with difficult laparoscopic cholecystectomy using SPSS software. Next, a correlation matrix was developed to evaluate correlation between individual parameters. Results: age (>65 years), obesity (BMI>30), male gender, fever, past history of upper abdominal pain (acute cholecystitis/ pancreatitis), post ercp status, leukocytosis, abnormal LFT and amylase level, increased CRP levels ,ultrasound whole abdomen parameters like thickened gallbladder wall ,gallbladder excessive distension or fibrosed gallbladder, calculi size and numbers, pericholecystic fluid ,hepatomegaly ,cirrhosis of liver, portal hypertension etc. are predictive markers of Difficult Laparoscopic Cholecystectomy both in viral marker positive( HBsAg, HCV, HIV) and negative patients. In 51.72% cases (90 patients) (n=174) laparoscopic cholecystectomy was difficult, out of these 40% (36 patients, n= 90) were viral marker positive patients.
Authors and Affiliations
Dr Mishra Shashank, Dr Kansal Sumit, Dr Vishnoi Anshul, Dr Bansal Rani, Dr Tyagi Ruchi, Dr Kumar Dhanesh
Keywords
Related Articles
- EP ID EP239207
- DOI 10.9790/0853-1610024559
- Views 81
- Downloads 0
Metastatic Ewing’s Sarcoma in Mandible: A Rarity
Ewing’s sarcoma, a malignant tumor, rarely occurs in children younger than 12 years of age. Although it may appear in any bone, it is more common in the axial skeleton, rarely involving the jaws (1 to 2 % incidence, most...
Functional Outcome of Bimalleolar Ankle Fractures Treated With Semitubular Plate for Lateral Malleolus and Malleolar Screws for Medial Malleolus
Background: Malleolar injuries are the most common significant lower extremity fractures. These injuries gain importance, because the whole body weight is transmitted through the ankle, and locomotion depends on the stab...
Occurrence of Hookworm–Whipworm co-infection among the HIV/AIDS patients of Noney district of Manipur, India
As a part of the on-going research work and in continuation of an existing programme pertaining to the copro-parasitological survey work on the prevalence and epidemiology of enteric parasitosis associated with HIV/AIDS...
A Retrospective Study on Post Burns Bacterial Infection Spectrum
Background: Burn wound infections diagnosis and treating them appropriate antibiotics can prevent bacteremia, sepsis or multiple organ dysfunction syndrome. Also early detection of organisms can prevent delayed healing a...
Comparison of two Different Dosages of Tranexamic Acid in Spine Fixation Surgery: A Randomized, Prospective Study
Introduction: Perioperative use of tranexamic acid (TXA) in major spine surgeries is known to reduce blood loss and thereby decrease the need for blood transfusion. However the optimal dosing of TXA remains highly contro...