COMPARISON OF GALL BLADDER REMOVEL WITH AND WITHOUT ENDOBAG DURING LAPAROSCOPIC CHOLECYSTECTOMY IN TERM OF PORT SITE INFECTION

Abstract

INTRODUCTION: Laparoscopy has become the gold standard approach to cholecystectomy since its introduction 30 years ago, and is one of the most commonly performed general surgical procedures¹. LC compared to open approach is the treatment of choice for symptomatic cholelithiasis with the proven benefits of less postoperative pain, shorter hospital stay, improved cosmesis, and increased patient satisfaction². The present study will compare the port site infection (PSI) in patients whose gallbladder is removed using an endobag compared to no use of endobag. As mentioned above, the retrieval of GB during LC remains a permanent challenge despite huge advances in its operative procedures and perforation of GB during LC can lead to significant morbidity particularly in term of PSI. The results of this study will be compared with other local surgeons and on the basis of results of this study, we will be able to draw conclusions for future research and policy recommendations.

OBJECTIVE: To compare the port site infection between endobag versus no endobag for gallbladder removal during laparoscopic cholecystectomy.
METHODOLOGY: This study was carried out at the department of Surgery, Lady Reading hospital, Peshawar.  Study Design was randomized controlled trial and the period of study was one year from 10th September 2019 to 9th September 2020. The sample size was 448 (224 in each group). All the patients undergoing single port LC for chronic cholecystitis with ASA class 1 and 2, age between 20 – 60 years and either gender were included. All the patients were randomly allocated in two groups by blocked randomization. Patients in group A were subjected to LC with use of endobag for retrieval of GB while patients in group B was subjected to LC with no endobag use for GB retrieval. Once the surgery is completed, standard post-operative protocols was maintained for all patients which includes triple antibiotic regime for all patients, analgesics and daily wound dressings. All the patients were followed up for the next 30 days to detect port site infection. The data collected was analyzed in SPSS version 22.
RESULTS: In this current study patients in group A were subjected to LC with use of endobag for retrieval of GB while patients in group B was subjected to LC with no endobag use for GB retrieval. Mean age in Group A was 44 years with SD ± 15.71 while mean age in Group B was 45 years with SD ± 14.39. In Group A 87(39%) patients were male and 137(61%) patients were female while in Group B 83(37%) patients were male and 141(63%) patients were female. In Group A 4(2%) patients had port site infection and 220(98%) patients didn’t had port site infection while in Group B 13(6%) patients had port site infection and 211(94%) patients didn’t had port site infection.

CONCLUSION: Our study concludes that port site infection was low in endobag as compare to no endobag for gallbladder removal during laparoscopic cholecystectomy.