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Category: Volume 07 Issue 07 July 2019
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Title: Is Endobag Retrieval of Gallbladder a must after Laparoscopic Cholecystectomy– Our Experience

Authors: Dr Narayanswamy T., Dr Prajwal R K, Dr Jose Francisco, Dr Vinayaka N S

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.20

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 the safety of gallbladder retrieval without the use of endobags.

Methods: This comparative prospective study was conducted at the KIMS hospital Bangalore, for a period of two years from April 2016 to March 2018. Data were collected on patient demographics, the use of a bag, any need for extension of fascial incision, port site infections, time for extraction of specimen and presence of port site hernia.

Results: There were 230 laparoscopic cholecystectomies performed during the study period. A bag was used to retrieve the gallbladder [Group A] in 37.3 % (n = 86) patients. A retrieval bag not was used in the majority of patients [Group B] (62.6 %). Overall wound infection rate was low (3.5 %), with 75 %(n = 6) ofthose being in patients where no retrieval bag was used. An increase incision in the fascia was required in 5.2 % of patients. The majority of these were in patients in whom a retrieval bag was used 91 % (n = 11). At 1 year follow up, two (1.3%) cases of port site hernia for the no retrieval bag group and one (1.1 %) cases of epigastric port site hernias in the group where retrieval bag was used.

Conclusion: In this study it is observed that epigastric port retrieval without endobag resulted in more port site wound infection, most of it was acute cases, but in cases of uncomplicated laparoscopic cholecystectomy for sonologically confirmed benign disease there was no benefit in using a retrieval bag. Furthermore, port site hernia was comparable between both groups, not using a bag was associated with less need for increasing the size of the fascial incision thereby reducing post-operative pain and time for extraction

Keywords: Laparoscopic cholecystectomy, endobag, port-site hernia, retrieval of gall-bladder.

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Corresponding Author

Dr Prajwal R K

Resident in Dept. of Surgery, Kempegowda Institute of Medical Sciences and Research Centre, K.R Road, VV Puram, Bangalore Pin: 560004, India