Author(s): P. Amutha1, M. Lakshmi Narayanan2, Arun Prabhu
Laparoscopic Cholecystectomy (LC) is one of the most common laparoscopic procedures being performed by general surgeons all over the world. Preoperative prediction of the risk of conversion is an important aspect of planning laparoscopic surgery. The purpose of our prospective study was to analyse various risk factors based clinical history, laboratory investigations and imaging and their association with conversion to open. With the help of accurate prediction, high-risk patient maybe informed beforehand regarding the probability of conversion and hence they may have a chance to make arrangements accordingly. On the other hand, surgeons also may have to schedule the time and team for the operation appropriately. Surgeons can also be aware about the possible complications that may arise in high-risk patients.
MATERIALS AND METHODS
Patients who presented to the Emergency Department in Government Rajaji Hospital with clinical diagnosis of duodenal ulcer perforation during the period of 6 months from March 2015 to August 2015 were prospectively nonrandomised (by consent and cafeteria method) to undergo either laparoscopic or open repair of duodenal ulcer perforation.
There was no significant difference in duration of symptoms, mean age, ASA grade and mean perforation size in both groups. Analgesic requirement was significantly lower in the laparoscopy group (3.39 ± 0.58 vs. 4.84 ± 0.66 days). Our patients who underwent laparoscopic repair were enabled to be discharged significantly earlier from the hospital (8.6 ± 2.3 vs. 10.5 ± 3.9 days. We found that laparoscopic repair did result in earlier return to normal diet (4.26 ± 0.81 vs. 4.87 ± 0.86 days). Time required for mobilisation of patients was also significantly lower (3.3 ± 0.7 vs. 4.34 ± 0.62 days).
Laparoscopic repair of dodenal ulcer perforation is as safe and effective as open repair has the advantages of less woundrelated complications, early recovery and return to normal activity.