International Journal of Science and Research (IJSR) ISSN: 2319-7064 Index Copernicus Value (2016): 79.57 | Impact Factor (2017): 7.296 Volume 7 Issue 9, September 2018 www.ijsr.net Licensed Under Creative Commons Attribution CC BY A Clinical Study of Cholecystectomies in PGIMS, Rohtak Dipanshu Gupta, Ashish Anand, Md Taquedis Noori, Anil Mehta, Pradeep Garg, Rajesh Godara Department of General Surgery, PGIMS, Rohtak, Haryana, India Abstract: Gall stones constitute a significant health problem in developed societies. Risk factors for gall stone disease are family history and genetics, age (incidence increases with age), gender and female sex hormones, obesity, dyslipidaemia, diabetes mellitus and the metabolic syndrome, rapid weight loss, total parenteral nutrition, life style factors and socioeconomic status, reduced physical activity heightens the risk of gall stone disease whereas increased physical activity prevent cholelithiasis. laparoscopic cholecystectomy decreases the postoperative pain , decrease the need for postoperative analgesia, shortens the hospital stay to less than 24 hours and returns the patient to full activity within one week (compared with one month after open cholecystectomy). This study was done to recognise the rates of laparoscopic and open cholecystectomies in our institute and the factors influencing the choice of one over the other and conversion rates. Keywords: Open Cholecystectomy, laparoscopic cholecyctectomy, conversion 1. Introduction Gall stones constitute a significant health problem in developed societies. Risk factors for gall stone disease are family history and genetics, age (incidence increases with age), gender and female sex hormones, obesity, dyslipidaemia, diabetes mellitus and the metabolic syndrome, rapid weight loss, total parenteral nutrition, life style factors and socioeconomic status, reduced physical activity heightens the risk of gall stone disease whereas increased physical activity prevent cholelithiasis. 1 laparoscopic cholecystectomy decreases the postoperative pain , decrease the need for postoperative analgesia, shortens the hospital stay to less than 24 hours and returns the patient to full activity within one week (compared with one month after open cholecystectomy) 2 . This study was done to recognise the rates of laparoscopic and open cholecystectomies in our institute and the factors influencing the choice of one over the other and conversion rates. 2. Methods 200 Patients of all age groups and both sexes who underwent cholecystectomy in various units of department of surgery, PGIMS Rohtak were included in the study. Cases of acute cholecystitis, Cases of Carcinoma Gall bladder and Cases of GB perforation were excluded from the study. All patients were admitted from surgery OPD. Based on history, clinical examination and ultrasonographic findings the diagnosis of cholelithiasis was made. Patients were sent for hematological investigations like hemoglobin, Bleeding time, Clotting time, TLC, DLC, Platelets, Blood urea, Random Blood Sugar levels, Serum electrolytes, Liver investigations like urine examination, ECG and Chest X ray were also done. After all investigations patient were sent for Preanaesthetic checkup. Patients were admitted and detailed informed and written consent was taken from the patients and their attendants. Patients then underwent open or laparoscopic cholecystectomy depending on the will of patient, any co morbid conditions, surgeon’s choice or availability of resources. Operative findings were noted. 3. Results Mode of Surgery Following was the pattern of surgery Table 1: Mode of Surgery Mode of Surgery Percentage Laparoscopic Mode 71 Open Surgery 25.5 laparoscopic to open conversion 3.5 Total 100 Reasons for conversion Following were the various reasons for conversion from LC to OC. Table 2: Reasons for conversion Reasons for conversion Percentage Iatrogenic Gut injury 14 Frozen calot's triangle 43 Mirizzi's syndrome 29 Hydatid cyst liver 14 Total 100 Table 2. shows various reasons for conversion from LC to OC. 3 patients required conversion due to dense adhesions present at calot's triangle, 2 patients were converted due to Mirizzi's syndrome while in one patient there was Iatrogenic Gut injuryfor which the procedure was converted to OC. Paper ID: ART20191513 DOI: 10.21275/ART20191513 1510