Laparoscopic Cholecystectomy: Use of the Surgical Glove for Extraction of Gallbladder and Spilled Gallstones Where Traditional Endobag is Not Available or Expensive
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 1
Abstract
Background: Laparoscopic cholecystectomy (LC) may be associated with intraoperative gallbladder perforation with bile and gallstones spillage. This causes peritoneal and extraction port site contamination. Objectives: To evaluate extraction time, safety, cost effectiveness and incidence rates of intraperitoneal and port site infections when a sterile surgical glove is used as an endobag for extraction of gallbladder specimen and spilled gallstones where the traditional endobag is not available or expensive. Methods and Patients: This is a prospective observational (cross-sectional) study conducted in AL-Karama Teaching Hospital/ Medical College/ Wasit University/ Iraq. A total of 473 patients who were laparoscopically cholecystectomised for symptomatic cholelithiasis, were included in this study. The patients were divided into 3 groups: Group I included 185 patients with non-perforated gall bladders which were directly extracted without endobag, Group II included 145 patients with non-perforated gallbladders extracted by surgical glove-endobag and Group III included 143 patients with intraoperatively perforated gallbladders extracted by surgical glove-endobag. The follow-up period ranged from 6 to 66 months. Results: Time Mean±SD of gallbladder/ spilled stones extraction of Groups I, II and III were: 5.87±4.46 minute (m), 8.73± 3.73 m and 10.78±4.42 m respectively. Incidence rates of port site infection of Groups I, II and III were: 9.18%, 0% and 2.8% respectively. Incidence rates of port site hernias of Groups I, II, III were: 2.16%, 0 % and 0.7 % respectively. Conclusion: LC is associated with increased incidence of intraoperative perforation of the gallbladder along with spillage of bile and stones. This prolongs time of gallbladder extraction and increases incidence rates of peritoneal and extraction port site infections. Use of the surgical glove as an endobag shortens the operative time and reduces septic complications of various laparoscopic procedures as well as LC.
Authors and Affiliations
Jawad Kadhim S. Al-Dhahiry, Hassan Khalil Melek, Tareq Khalid Abduljabbar
Keywords
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- EP ID EP541068
- DOI 10.21276/ijmrp.2017.3.1.010
- Views 71
- Downloads 0
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