Incidence of Port Site Infection After Laparoscopic Cholecystectomy: Our Experience at Hayatabad Medical Complex
DOI:
https://doi.org/10.37762/jgmds.10-2.446Keywords:
Dorsal Spine Tuberculosis, Corpectomy with Fusion, Laminectomy, Outcome MeasuresAbstract
OBJECTIVES
This study aimed to assess the factors that affect post-laparoscopic cholecystectomies PSI and determine which characteristics can be changed to prevent PSI in a trial to maximize the benefits of laparoscopic surgery.
METHODOLOGY
The study included all patients who experienced port site infection following laparoscopic cholecystectomy. All patients received Inj Ceftriaxone 1gm pre-operatively & then twice a day postoperatively for 03 days. In all operations, the gallbladder is removed from the epigastric port without using a retrieval bag by skilled surgeons employing four-port methods and reusable equipment. Most patients had the sub-hepatic tube drain placed and were discharged the day after surgery.
RESULTS
Acute cholecystitis was the most common operative finding with port-site infection, i.e. 6(42.8%), second being empyema that was seen in 3(21.4%) patients, 2(14.3%) patients had bad adhesions, mucocele in 2(14.3%) patients and thick walled gall bladder with stones was found in 1(7.1%) patients respectively, indicating that the relationship between infection and acute cholecystitis is significant. Regarding the spills of bile, stones, or pus, 3(21.4%) patients had infections despite there being no spillage, while 11(78.6%) patients developed an infection while the spillage happened during their procedures. The p-value was 0.0001, meaning that the spillage might be considered a risk factor for the development of port site infection.
CONCLUSION
The spilling of bile, stones, or pus, the port of gallbladder removal, and acute cholecystitis are all strongly associated with port site infection. Given that Mycobacterium tuberculosis may be the source of chronic deep surgical site infections, more care should be exercised. The majority of PSIs are superficial and more prevalent in men.
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Garmpis N, Dimitroulis D, Garmpi A, Diamantis E, Spartalis E, Schizas D, Angelou A, Margonis GA, Farmaki P, Antoniou EA, Mantas D. Enhanced recovery after surgery: is it time to change our strategy regarding laparoscopic colectomy?. in vivo. 2019 May 1;33(3):669-74
Miron A, Enciu O, Toma EA, Calu V. Risk Assessment and learning curve in laparoscopic transperitoneal adrenalectomy-early and late experience of a single team. Chirurgia (Bucur). 2019 Sep 1;114(5):622-9
Gibson E, Fransson BA, Dupre G. Laparoscopic access and the working space. Small Animal Laparoscopy and Thoracoscopy. 2022 Mar 1:92-105
Madhok B, Nanayakkara K, Mahawar K. Safety considerations in laparoscopic surgery: a narrative review. World Journal of Gastrointestinal Endoscopy. 2022 Jan 1;14(1):1
Arab W. Diagnostic laparoscopy for unexplained subfertility: a comprehensive review. JBRA Assisted Reproduction. 2022 Jan;26(1):145
Gu S, Wang Y, Bao J, Luo H. Optimizing the working space for single-port laparoscopic totally extraperitoneal closure of inguinal hernia with TPV protocol in infants and young children. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2022 Jun 1;32(6):690-5
Whitfield N. A revolution through the keyhole: technology, innovation, and the rise of minimally invasive surgery. The Palgrave Handbook of the History of Surgery. 2018:525-48
Khan A, Ahmad T, Jan H, Ali IS, Riaz M, Khan MM. Outcomes of a modified open technique of umbilical camera port insertion in laparoscopic cholecystectomy. Pak J Surg. 2019;35(2):89-93
Koo JG, Chan YH, Shelat VG. Laparoscopic subtotal cholecystectomy: comparison of reconstituting and fenestrating techniques. Surgical Endoscopy. 2021 Mar;35:1014-24
Yan Y, Sha Y, Yuan W, Yuan H, Zhu X, Wang B. One-stage versus two-stage management for acute cholecystitis associated with common bile duct stones: a retrospective cohort study. Surgical Endoscopy. 2021 Mar 31:1-0
Nugent JP, Li J, Pang E, Harris A. What’s new in the hot gallbladder: the evolving radiologic diagnosis and management of acute cholecystitis. Abdominal Radiology. 2022 Mar 1:1-6
Onoda T, Sato M, Torii K, Inamori K, Okada E, Nozawa M, Shiiya N, Wada H. A negative pressure–based visualization technique for abdominal Veress needle insertion. Langenbeck’s Archives of Surgery. 2022 Aug;407(5):2105-13
Jamil M, Niaz K, Tahir F. Closed vs. open method of pneumoperitonium at infra-umbilical site in laparoscopic surgery-A comparative study. J. Pak. Med. Assoc. 2018 Oct 1;68:1478-82
Lima DL, Lima RN, Dos Santos DC, Shadduck PP, Carvalho GL, Malcher F. Which cholecystectomy technique would surgeons prefer on themselves?. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2020 Dec 15;30(6):495-9
Maurya AK, Nag VL, Kant S, Sharma A, Gadepalli RS, Kushwaha RA. Recent methods for diagnosis of nontuberculous mycobacteria infections: Relevance in clinical practice. Biomedical and Biotechnology Research Journal (BBRJ). 2017 Jan 1;1(1):14
Ryu YJ, Koh WJ, Daley CL. Diagnosis and treatment of nontuberculous mycobacterial lung disease: clinicians perspectives. Tuberculosis and respiratory diseases. 2016 Apr 1;79(2):74-84
Devana JV, Calambur N, Reddy BR. Pacemaker site infection caused by rapidly growing nontuberculous mycobacteria (RGM). Biomedical and Biotechnology Research Journal (BBRJ). 2018 Jan 1;2(1):82
Espinosa JA, Sawyer R. Surgical site infections. In: Cameron AM, Cameron JL, editors. Current Surgical Therapy. Philadelphia, PA: Elsevier; p. 1337–44
Kulaylat MN, Dayton M;., Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Surgical complications. In: Sabiston Textbook of Surgery. Philadelphia, PA: Elsevier; 2017
Weiser MC, Moucha CS. Surgical site infection prevention. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, editors. Skeletal Trauma: Basic Science, Management, and Reconstruction. Philadelphia, PA: Elsevier;
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Copyright (c) 2023 Rashid Aslam, Farrukh Ozair Shah, Muhammad Alam Alam, Shehzad Akbar Khan
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