Research Article Int J Cur Res Rev | Vol 8 • Issue 1 • January 2016 1 RETROSPECTIVE ANALYSIS OF CHOLECYSTECTOMY PERFORMED IN AN INSTITUTION FOR LOWER SOCIOECONOMIC POPULATION IN INDIA Tanweer Karim, Subhajeet Dey, Rabishankar Singh, Vivek K. Katiyar Department of Surgery, ESIC PGMSR & Model Hospital, Basaidarapur, New Delhi-110015 ABSTRACT Background: Gallstones are common in Indian population.Laparoscopy requires longer and steeper learning curve and proper patient selection. Patients belonging to lower socioeconomic group usually present late, develop one or the other complications of cholelithisis prior to surgery and expected to have higher conversion rate, per-operative and post-operative complications. Aims: To study safety and efficacy of laparoscopic cholecystectomy in patients of cholelithiasis by comparing with results of open cholecystectomy in terms of use of post-operative analgesia, operative Time, post-operative hospital stay, morbidity and mortality. Material and Method: Patients operated for gallbladder stone betweenJanuary 2013 and August 2015were retrospectively analyzed in terms of demographic profile, clinical presentation, procedureperformed and its findings, operating time, conversion rate, postoperative pain and analgesic requirement, postoperative hospital stay and complication. Results: Cholecystectomy was performed in 630 patients between January 2013 and August 2015. 368 patients were operated laparoscopically and 232 patients by open method. It comprises of almost 25 percent of major operations performed during this period, 75.8% were females and 9 of them were less than 15 years of age. The mean operating time during 2013 for laparo- scopic and open Cholecystectomy was 68.37 minutes and 66.20 minutes, decreased to 46.27 minute and 53.33 minute during 2014-15, respectively. Intraoperative cholangiography was not required in any case. Conclusion: Cholelithiasis is relatively common in India even in lower socio-economic group. Dietary habits and obesity do not appear as contributing factor.Laparoscopy has better visibility, access and operating time than open cholecystectomy. Compli- cations rate is negligible even in difficult gallbladders, if proper planning is done with ultrasonography and liver function test 24 hours prior to surgery. Key Words: Laparoscopic cholecystectomy, Open cholecystectomy, Cholelithiasis, Obstructive jaundice, Pancreatitis Corresponding Author: Tanweer Karim, Department of Surgery, ESIC PGMSR & Model Hospital, Basaidarapur, New Delhi-110015 E-mail: karimtanweer@yahoo.co.in Received: 20.11.2015 Revised: 09.12.2015 Accepted: 25.12.2015 INTRODUCTION Laparoscopic cholecystectomy is a revolutionary change in the treatment of patients with gallbladder stones. Mouret in- troduced laparoscopic cholecystectomy in 1987 [1] . It has rapidly replaced open cholecystectomy as the standard treat- ment. Advantages of laparoscopic cholecystectomy include reduced hospitalization, decreased morbidity, short recovery time, and better cosmesis [2] .Laparoscopic cholecystectomy though safe and effective, yet can be difficult at times. Vari- ous problems faced are difficulty in creating pneumoperito- neum, accessing peritoneal cavity, releasing adhesions, iden- tifying anatomy, anatomical variation and extracting the gall bladder. Laparoscopic cholecystectomy with these problems along with time taken more than normal is considered as difficult.Pre-operative prediction of a difficult laparoscopic cholecystectomy can help the patient as well as the surgeon prepare better for the intra-operative risk and the risk of con- version to open cholecystectomy. AIMS To study safety and efficacy of laparoscopic cholecystecto- my in patients of cholelithiasis by comparing with results of IJCRR Section: Healthcare Sci. Journal Impact Factor 4.016