Shakeel Ahmad Mi
BACKGROUND Surgical site infection (SSI), a significant postoperative complication, can lead to considerable patient morbidity and mortality1 . Preventing postoperative infection is an essential factor in improving the results of surgical procedures. At present, laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic cholelithiasis. The incidence of infectious complications after LC is significantly lower compared to infections with open cholecystectomy. MATERIALS AND METHODS The study was conducted in the Post graduate Department of Surgery, Govt. Medical College, Srinagar over a period of two years from December 2015 to December 2017. This study is prospective in design comprising of 100 cases of cholelithiasis diagnosed by ultrasonography, undergoing Laparoscopic Cholecystectomy and fulfilling the inclusion and exclusion criteria. RESULTS Mean age of patients in our study was 37.3 years ± 10.14 most of our patients were of the age group of 40-49 comprising of 42% and least were of the age group of 10-19 years comprising of 7%. Sex distribution in our study- most of them were females 61% followed by males who were 39%. Among 100 patients in our study of uncomplicated gall stones with bile spillage, bile culture was positive in 17 patients and 6 among these 17 developed port site infection and rest 11 didn’t have any wound infections. Remaining 83 patients with spillage had negative bile cultures and only 3 had wound infection which is statistically significant with P value of 0.0006. So far as wound site infection was concerned among 100 patients in our study with bile spillage, superficial wound site infection was found in 9 patients (i.e. 100%) with no deep wound site infection in any patients. CONCLUSION Gall bladder spillage is an uncommon occurrence in most of the cases but when it occurs main goal of all surgeons should be to manage these complications with minimal harm to the patients. Whenever spillage of bile occurs during laparoscopic cholecystectomy, it’s advisable to take sample of bile for culture and sensitivity and treat that patient accordingly.
