الفهرس | Only 14 pages are availabe for public view |
Abstract Background: The surgical management of gall stone disease has been revolutionized by laparoscopic surgery through reducing post-operative pain, incisional hernia, risk of surgical infection, as well as blood loss. Objectives: The aim of this study is to compare port-site complications after gall bladder retrieval from epigastric vs. umbilical port in laparoscopic cholecystectomy. Patients and Methods: This study was undertaken to determine whether gall bladder (GB) retrieval from umbilical port is associated with more complication at respective port site as compared to GB retrieval from epigastric port in adult patients undergoing four port elective laparoscopic cholecystectomy (LC) at a tertiary care hospital. A total 80 patients with chronic cholecystitis (18-60 years old) was investigated, operated upon using laparoscopy, under GA and followed up post-operatively for 6 months for port-site complication and their final outcome was evaluated. This study was conducted at Ahmed Maher teaching hospitals. We had included 80 patients, who underwent elective laparoscopic cholecystectomy for benign GB diseases (symptomatic gallstones, GB polyps) and patients in whom informed consent was obtained. Patients was randomly divided into either group A and group B. We had followed up patients for 6 months for postoperative port site complications (pain, bleeding, infection and hernia). Results: Our study indicates a statistically significant reduction in post-operative pain in gall bladder extraction via umbilical port as compared to that of epigastric port. Furthermore, the Port site infection is also lower in Group-A patients (gall bladder extraction via epigastric port). But there was no statistical difference between the two groups in terms of post retrieval bleeding. Despite lower incidence of port site hernia among group A (epigastric port) the results remain statistically non-significant. Conclusion: Our study indicates that, regarding gallbladder retrieval during laparoscopic cholecystectomy, umbilical port is superior to epigastric port in terms of post operative pain. Additionally, epigastric port has lower incidence of port site infection while no port is better regarding post retrieval bleeding. In spite of lower rate of port site hernia in epigastric group further studies are needed to prove statistical significance. |