DOI: 10.21276/aimdr.2017.3.2.SG13 Original Article ISSN (O):2395-2822; ISSN (P):2395-2814 Annals of International Medical and Dental Research, Vol (3), Issue (2) Page 63 Section: Surgery A Prospective Study of 100 Consecutive Laparoscopic Cholecystectomies. Farhanul Huda 1 , Abhijit Kumar 2 , Sudhir Kumar Singh 2 1 Associate Professor, Department of General Surgery, All India Institute of Medical Sciences, Rishikesh. 2 Senior Resident, Department of General Surgery, All India Institute of Medical Sciences, Rishikesh. Received: February 2017 Accepted: February 2017 Copyright: © the author(s), publisher. Annals of International Medical and Dental Research (AIMDR) is an Official Publication of “Society for Health Care & Research Development”. It is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Cholelithiasis, the leading cause for hospital admissions related to gastrointestinal problems, had been traditionally dealt by open cholecystectomy. Erich Muhe performed the first laparoscopic cholecystectomy on September 12, 1985. In September 1992, a National Institute of Health (NIH) consensus conference held in Bethesda concluded that laparoscopic cholecystectomy should be the treatment of choice for gallstone disease. This study on laparoscopic cholecystectomy was done to illustrate the clinical manifestations and peroperative findings in gallstone disease. Methods: We prospectively studied 100 consecutive cases undergoing laparoscopic cholecystectomy at our institute. Presenting complaints, laboratory investigations and USG findings were noted. Standard 4-port laparoscopic cholecystectomy was performed, with closed method using Veress needle preferred for the first (umbilical) port. All peroperative findings were analyzed. Results: Majority of the patients were female (79%), and the average age of the patients was 40.18 years. Pain in upper abdomen was the most common presenting complaint (93%) and an association with meal was found in 85%. Peroperatively, multiple calculi were found in 77%, with impaction of calculus at neck seen in 10% of the patients. Distended gall bladder was seen in 19%, and mucocele in 3%. Shrunken gall bladder was observed in 4%. Difficult Calot’s triangle, due to adhesions, was found in 22%. Biliary tree or vascular anomaly was seen in 8%. Mean postoperative hospital stay was 1.92 days. Conclusion: Pain abdomen in gallstone disease is commonly seen in association with meals. Thick-walled gall bladder, adhesions at Calot’s triangle, and distended gall bladder are common peroperative findings. Keywords: Laparoscopic, cholecystectomy. INTRODUCTION Gallstone disease constitute a major health problem in society, affecting 10% to 15% of the adult population. [1-3] In both the sexes, the prevalence increases with age. [1,4] Male:female ratio is 1:2, and female gender has the most compelling association with the gallstone disease, particularly during the fertile years. [1] Obesity and family history are the other significant risk factors. [1,5-8] Name & Address of Corresponding Author Dr. Abhijit Kumar Senior Resident, Department of General Surgery, All India Institute of Medical Sciences Rishikesh. The majority of patients with gallstone, upto 80%, remain asymptomatic for the lifetime. [9] To become symptomatic, gallstone must obstruct a visceral structure, such as the cystic duct. Biliary colic develops when the stone causes a transient blockade of cystic duct, and it tends to occur following a meal. This is due to increased secretion of cholecystokinin, which leads to contraction of gall bladder, propelling the calculi towards the neck. People with “silent” gallstone, may eventually develop pain or other symptoms, but this risk is very low averaging 2% to 3% annually, and upto 10% by 5 years. [10-12] An even lower proportion, 1% to 2% per year, may present for the first time with major gallstone complications. [13,14] Our study was a prospective study, to illustrate various clinical manifestations, and intraoperative findings in gallstone disease. Aim To study the clinico-epidemiological profile and peroperative findings of gallstone disease. MATERIALS AND METHODS This was a prospective analytical single center study. In this study, 100 consecutive non-emergent cases of gall bladder disease admitted in the department of surgery were included. Age-sex distribution, weight, past history of abdominal surgery, and associated comorbidities were recorded. Investigations included a complete blood count, blood sugar, liver and kidney function tests, electrocardiogram, x-ray chest, and abdominal sonography.