Abstract
Background: Since the introduction of laparoscopic cholecystectomy different methods of retrieval have been used to extract the gallbladder from the peritoneal cavity. Various studies have shown the advantages of retrieval with endobag, this study aimed at evaluating efficacy of endobags in prevention of port site infections in histologically proven cholecystitis.
Methods: This retrospective study was conducted at the KIMS hospital Bangalore, for a period of four years from April 2015 to March 2019. Data were collected on patient demographics, the use of a bag, port site infections and final Histopathology of Gallbladder specimen.
Results: There were 270 Histologically proven cholecystitis during the study period. A bag was not used to retrieve the gallbladder [Group A] in 39.6 % (n = 104) patients. A retrieval bag was used in the majority of patients [Group B] (62.6 %). Overall wound infection rate was 7.2 %, with 80 %(n = 16) ofthose being in patients where no retrieval bag was used.
Conclusion: In this study it is observed that epigastric port retrieval without endobag resulted in more port site wound infection and use of endobag was associated with less port site infections but has its own disadvantages like increase need for extension of facial incision and longer operating time.
Keywords: Laparoscopic cholecystectomy, endobag, port-site infection, retrieval of gall-bladder.
References
- Ali SA and Siddiqui FG (2013). Implanted gallstones at port site (A Case Report). World J. Min. Access. Surg.,2: 11-14.
- Brockmann JG, Kocher T, Senninger NJ and Schurmann GM (2002). Complications due to gallstones lost during laparoscopic cholecystectomy: An analysis of incidence, clinical course and management. Endosc., 16: 1226-1232.
- Golash V and Rahman S (2006). Railroading removal of gall bladder in laparoscopic cholecystectomy. Minim.Access. Surg., 2(1): 31-32.
- Hand AA, Self ML and Dunn E (2006). Abdominal wall absces formation ten years after laparoscopic Cholecystectomy. JSLS., 10(1): 105-107.
- Helme S, Samdani T and Sinha P (2009). Complications of spilled gallstones following laparoscopic cholecystectomy, a case report and literature overview. Med. Case Reports, 3: 8626.
- Kang KJ and Lim Tae Jin (2003). Tip for microlaparoscopic cholecystectomy, easy removal of the gallbladder after laparoscopic cholecystectomy using the three-port technique. Laparosc. Endos.Percutan. Tech., 13: 118-120.
- Kumar TS, Saklani AP, Vinayagam R and Blackett RL (2004). Spilled gall stones during laparoscopic cholecystectomy, a review of the literature.
- J., 80: 77-79.
- Leggett PL, Churchman-Winn R and Miller G (2000), Minimizing ports to improve laparoscopic cholecystectomy. Endosc., 14: 32-36.
- Lrkorucu O, Tascilar O, Emre AU, Cakmak GK, Ucan BH and Comert M (2008). Missed gallstones in the bile duct and abdominal cavity: A case report. Clinics (Sao Paulo)., 63: 561-564.
- Machado MAC and Herman PA (2004). Simple technique for removal of gall-bladder during micro laparoscopic cholecystectomy. Endose., 18: 1289-1290.
- Memon AI, Ali SA and Soomro AG et al. (2013). A safe and inexpensive technique of retrieval of gallbladder specimen after laparoscopy. J. Med Science, 2(11): 219-224.
- Memon MR, Arshad S, Rafiq S, Bozdar AG and Shah SQA (2011). Port-site hernia: A serious complication of laparoscopy. Med. J., 36(1): 14-17.
- Mohiuddin K, Nizami S and Fitzgibbons RJ jret al (2006). Predicting iatrogenic gall-bladder perforationduring laparoscopic cholecystectomy: A multi-variate logistic regression analysis of risk factors. J. Surg., 76: 130-132.
- Sanz-Lopez R, Martinez RC and Nunez PJR et al. (1999). incisional hernias after laparoscopic vs open cholecystectomy. Endosc., 13: 922-924.
- Sathesh-Kumar T, Saklani AP, Vinayagam R and Blackett RL (2004). Spilled gallstones during laparoscopic cholecystectomy: A review of literature. Med. J., 80: 77-79.
- Shahzad K, Mian MA and Rehman JU (2007). Earlycomplications of laparoscopic cholecystectomy for calculus cholecystitis. Armed. Forces med. J.,4: 20-25.
- Sharma D, Patel K and Anchalia MM (2013). Study of cases of complications at port site. J. Sci. &Research (online), 2(12): 2319-7064.
- Woodfield JC, Rodgers M and Windsor JA (2004). Peritoneal gallstones following laparoscopic cholecystectomy: An analysis of incidence, clinical course and management. Endosc., 18: 1200-1207.
- Zehetner J, Shamiyeh A and Wayand W (2007). Lost gallstones in laparoscopic cholecystectomy: All possible complications. J. Surg., 193: 73-78.
Corresponding Author
Dr B Revanth Kumar
KIMS Bangalore