Study of operated patients of laparoscopy cholecystectomy without using energy source
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 10
Abstract
Introduction: Laparoscopic cholecystectomy (LC) is one of the most common surgeries performed by general surgeon. It is gold standard for symptomatic gall stone disease. But still it is not as safe as open surgery. Most of the surgeons uses electro thermal energy device to do dissection at callot’s triangle for coagulation of blood vessels and separation of gallbladder from liver bed. There were incidences of thermal injuries of biliary tree, vascular tree and bowels, duodenum. These types of injuries are dangerous and causing high level of morbidity and mortality. With great care also there are direct and spreading thermal injuries. Many of such injuries are not appreciated during surgery and reveal later on. We have done data analysis of Laparoscopic cholecystectomy without electro thermal energy. Objective: The main objective of study is to find reduction of complication rate without energy device in laparascopic cholecystectomy. To find the possibility of avoidance of injuries done by electrothermal devices , technical difficulty of surgery done without energy source, conversion rate for open and intraoperative and postoperative bleeding and other complications. Methods: We have done retrospective data analysis of 30 cases of laparoscopic cholecystectomy done by using hand laparoscopic instruments with standard four ports and without energy devices which includes both sexes with 20 to 75 yrs of age, between years 2011 to 2015 at Civil Hospital attached with GMERS medical college, Gandhinagar, Gujarat, India. The follow-up data of all patients were evaluated for operative and postoperative outcomes. Results: 29 out of 30 patients were operated by this method; 1patient was converted to open surgery because of difficult cholecystectomy and very dense adhesions. 1 patient had minimal bile leak which was stopped spontaneously. Not a single patient was converted to open because of bleeding and vision disturbances, not a single case of post operative haemorrhage .There was no hemodynamic instablility during and after surgery, no conversion to open due to no use of electrocautery , no injury of billiary tree, vacular or bowel and no mortality. Conclusion: Laparoscopic cholecystectomy without using energy source has advantage of preventing thermal injuries to biliary tree and bowels and vascular structures .It can be safely performed without using any energy source.
Authors and Affiliations
Umesh G Vaishnav, Harshad S Patel
Keywords
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