Comparative study of Port site infection after gall bladder retrieval using indigenously designed endo-bag and without using endo-bag in Laparoscopic Cholecystectomy
Abstract
Background: Laparoscopic Cholecystectomy is the most common minimally invasive surgical procedure performed worldwide to remove the diseased gallbladder and also the gold standard in the treatment of symptomatic gallstone. The study aims at assessing the comparative utility of indigenously designed endo-bag for gallbladder specimen extraction to prevent infection of the port site in laparoscopic cholecystectomy by using and without using a bag.
Material and Method: This randomized prospective study was conducted on fifty patients included using random sampling. A predesigned and validated proforma was used to record the clinical data. Indigenously designed endo-bag made of the sterile surgical glove was used for gall bladder specimen retrieval and the epigastric port was used as retrieval port. The port site was examined on a postoperative day three for any sign of wound infection. Follow up was done for any late infection.
Results: In the present study, 50 patients who underwent surgery only 1 patient was obese with a BMI of 32.38 mg/kg2. The incidence of PSI in patients who underwent the procedure using a bag was 4% whereas it was 8% in patients without a bag. This was significant with a p-value of 0.002. Distribution of appearance of port site infection in relation to various observational days, it was found that patients, where procedure was performed using bag, at day 3 one patient (4%), had PSI.
Conclusion: The incidence of infection at the port site was more among the patients where endobag was not used in comparison to those undergoing extraction with endobag.
Downloads
References
Gurusamy KS. Surgical treatment of gallstones. Gastroenterol Clin North Am. 2010;39(2):229-244. doi: https://doi.org/10.1016/j.gtc.2010.02.004.
Majid MH, Meshkat B, Kohar H, El Masry S. Specimen retrieval during elective laparoscopic cholecystectomy: is it safe not to usea retrieval bag? BMC Surg 2016;16:64. doi: https://doi.org/10.1186/s12893-016-0181-y.
Kang K J, LimT J. Tip for micro laparoscopic cholecystectomy, easy removal of the gallbladder after laparoscopic cholecystectomy using the three-port technique. Surg Laparosc Endos Percutan Tech. 2003;13(2):118-120. doi: https://doi.org/10.1097/00129689-200304000-00012.
Diez J, Arozamena C, Gutierrez L, Bracco J, Mon A, Almeyra RS, Secchi M. Lost stones during laparoscopic cholecystectomy. HPB Surgery. 1998;11(2):105-109. doi: https://doi.org/10.1155/1998/95874.
Zehetner J, Shamiyeh A, Wayand W. Lost gallstones in laparoscopic cholecystectomy: all possible complications. Am J Surg. 2007;193(1):73-78. doi: https://doi.org/10.1016/j.amjsurg.2006.05.015.
Murphy MM, Shah SA, Simons JP, Csikesz NG, McDade TP, Bodnari A, et al. Predicting major complications after laparoscopic cholecystectomy: a simple risk score. J Gastrointest Surg. 2009;13(11):1929-1936. doi: https://doi.org/10.1016/j.jamcollsurg.2010.02.050.
Kothapalli S, Kenawadekar R, Gogate A, Metgud S, Pattanshetti V. Efficacy of Powder-free Surgical Glove Bag Versus No Glove Bag For Retrieval Of The Gallbladder During Laparoscopic Cholecystectomy: A One Year Randomized Controlled Study. Era J Med Res. 2019;6(1):15-21.
Schulze S, Damgaard Bo, Kristiansen VB. Laparoscopic Treatment of Bile Duct Stones. Ugeskr Laeger. 2004;166(35):2985-2987.
Goetze TO, Paolucci V. Use of retrieval bags in incidental gallbladder Cancer cases. World J Surg. 2009;33(10):2161-2165. doi: https://doi.org/10.1007/s00268-009-0163-7.
Bonjer J. Surgical principles of minimally invasive procedures. Springer, Cham. doi: https://doi.org/10.1007/978-3-319-43196-3.
Samel S, Post S, Martell J, Becker H. Clostridial gas gangrene of the abdominal wall after laparoscopic Cholecystectomy J. Laparoendosc. Adv Surg Tech A. 1997;7(4):245-247. doi: https://doi.org/10.1089/lap.1997.7.245.
Al-Awami SM, Al-Breiki H, Abdul-Khader AS, Twum-Danso K, Grant C, Wosomu L. Wound infection following biliary surgery. A prospective study. Int Surgery. 1191;76(2):77-80.
La Regina D, Mongelli F, Cafarotti S, Saporito A, Ceppi M, Di Giuseppe M, et al. Use of retrieval bag in the prevention of wound infection in elective laparoscopic cholecystectomy: is it evidence-based? A meta-analysis. BMC Surg. 2018;18(1):1-7. doi: https://doi.org/10.1186/s12893-018-0442-z.
Rice DC, Memon MA, Jamison RL, Agnessi T, Ilstrup D, Bannon MB, et al. Long term consequences of intraoperative spillage of bile and gall stones during laparoscopic cholecystectomy. J Gastrointest Surg. 1997;1(1):85-90. doi: https://doi.org/10.1007/s11605-006-0014-x.
Memon AI, Ali SA, Soomro AG, Siddique AJ. A safe and inexpensive technique of retrieval of gallbladder specimen after laparoscopy. Scientific J Med Sci. 2013;2(11):219-224.
Ali SA, Siddiqui F G. Implanted gallstones at port site (A Case Report) . World J Min Access Surg. 2013;2(7).
Helme S, Samdani T, Sinha P. Complications of spilled gallstones following laparoscopic cholecystectomy; a case report and literature overview. J Med Case Reports. 2009;3:8626. doi: https://dx.doi.org/10.4076%2F1752-1947-3-8626.
Turk E, Karagulle E, Serefhanoglu K, Turan H, Moray G. Effect of cefazolin prophylaxis on postoperative infectious complications in elective laparoscopic cholecystectomy: a prospective randomized study. Iran Red Crescent Med J. 2013;15(7):581-586. doi: https://doi.org/10.5812/ircmj.11111.
Sathesh-Kumar T, Saklani AP, Vinayagam R, Blackett RL. Spilled gallstones during laparoscopic cholecystectomy, a review of literature. Postgrad Med J. 2004;80(940):77-79. doi: https://dx.doi.org/10.1136%2Fpmj.2003.006023.
Overby DW, Apelgren KN, Richardson W, Fanelli R. SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc. 2010;24(10):2368-2386. doi: https://doi.org/10.1007/s00464-010-1268-7.
Singh K, Walia DS, Singla A, Banal A, Jangir N. A comparison of benefits and complications of extraction of gallbladder in an endobag using a drain bag versus direct extraction. IJARS. 2018;7(1):SO13-SO18. doi: https://doi.org/10.7860/IJARS/2018/32069:2356.
Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
Therapoid
