Abstract

EVALUATION OF PORT SITE INFECTION FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY IN A GOVERNMENT TEACHING HOSPITAL

Author(s): Satish Kumar, Tripurari Pandey, Sanjeev Kumar Pathak

BACKGROUND The objectives of this study were to evaluate the frequency of port site infection following laparoscopic cholecystectomy, its prevention and its management. With the passage of time, laparoscopic cholecystectomy has revolutionized the ease of management of cholecystitis and associated gallbladder disease, but has been associated with catastrophic complication of port site infection. MATERIALS AND METHODS 400 cases of laparoscopic cholecystectomy were done at Dept. of surgery, Nalanda Medical College, Patna between March 2012 and 2018 (Feb) and were analysed for port site infection. Culture sensitivity was done for all patients who developed port site infection. Variables like port sites, port size, duration of operation time were evaluated. A search was also made for nontuberculous mycobacterium. RESULTS Out of 400 cases, 30 cases (7.5%) developed Port Site Infection. Out of these 15 cases (3.7%) had superficial infection while 12 cases (3%) had deep surgical infection. Five cases developed sinus formation due to (i). Retained nbecrotic foreign material and (ii). Infected suture material. Three cases developed nonhealing sinus which finally healed after treatment for Atypical Nontuberculous mycobacterium. 70% of cases of Port Site Infection developed at epigastric port, the port from which Gallbladder was taken out. In 95% of cases port site infection occurred in port size 10 mm or more. CONCLUSION Port site infection is more at the port from which Gallbladder is retrieved. Almost always occurred in port size of more than 10 mm size. Improved surgical training has resulted in decreased number of catastrophic complications of laparoscopic cholecystectomy. But has not impacted significantly on incidence of P.S. Infection.