Risk of Gastrointestinal Complications in Post Laparoscopic Cholecystectomy

Background: Post-cholecystectomy is related with a significant risk of developing gastrointestinal symptoms which affect the quality of life of patients. Objective: To assess the gastrointestinal complications risks in post-cholecystectomy patients (laparoscopic). Study Design: Retrospective study Place and Duration of Study: Department of Surgery, Services Hospital, Lahore from 1st April 2020 to 31st March 2021. Methodology: One hundred and fifty patients were enrolled. All patients under went laparoscopy for their acute or chronic cholelithiasis treatment. Patients demographic, body mass index, clinical assessment was documented. Patients were followed up for a period of six months and their gastrointestinal complains were recorded. Results: There were 86 females and 64 males with a mean age 49.8±6.3 years and mean body mass index were 24.8±3.6 kg/m2. Diarrhoea and fat intolerance were main complains within 56% and 57.3% patients within three months respectively. Flatulence, fat intolerance and right upper quadrant pain was also main complains of patients. Conclusion: Risk of diarrhoea, right upper quadrant pain, flatulence, and fat intolerance are noticeable as gastrointestinal complication in laparoscopic post-cholecystectomy patients. Keywords: Post-cholecystectomy, Gastrointestinal complications, Diarrhoea</jats:p

Association of Risk Factors for the Mortality and Morbidity of Stoma Closure

Background: Anastomal leakage is a main surgical difficulty and requires stoma closure. Objective: To find associated risks for mortality and morbidity of stoma closure. Study Design: Retrospective cohort study Place and Duration of Study: Department of Surgery Ward 2, Jinnah Sindh Medical University/Jinnah Postgraduate Medical Centre Karachi from 1st July 2020 to 30th June 2021. Methodology: One hundred and twenty patients undergone rectal carcinoma surgeries were enrolled. The complications were graded by Clavien-Dindo classification system. The stoma closure was done by two different methods; the anterior wall technique or resection with anastomosis. Time duration of surgery, scoring by American Society of Anaesthesiologists was done and clinical and demographic information documented. Results: There were 62.5% males while 37.5% females and mean age was 65.5±8.5 years range between 31 to 72 years. Vascular blood supply affected leaking anastomaly. No significant effect of stoma type or closing technique was seen. However the time of stoma (p=0.044) and ASA score closure was a main risk for causing complications and increasing morbidity or mortality chances. Conclusion: Time of closure, American Society of Anaesthesiologists score as well as vascular supply are risk factors for morbidity or mortality in stoma closure. Keywords: Surgical stoma closure, Risk factors, Morbidity, Mortality</jats:p

Factors Increasing Risk of Septicemia in Acute Cholycystectomy Patients

Background: Septicemia is defined as systematic inflammatory response syndrome which is formed as a result of an infection. Objective: To identify the factors increasing risk of septicemia in acute cholecystectomy patients. Study Design: Retrospective study Place and Duration of Study: Department of Surgery, Sahara Medical College, Narowal from 1st August 2020 to 31st May 2021. Methodology: One hundred and seventy acute cholecystectomy patients were enrolled. The patient’s demographic, clinical history, comorbidities and post-operative complications were listed. All procedures were done through laparoscopic method. Results: There were 54.1% females and 45.9% males. The mean age of patients was 52.17±14.33 years. There were 11.7% cases who developed septicemia. The immune deficient patients were 0.9% and 1.8% had perforated gall bladder. There were 2.7% cases having obesity, cirrhosis or complicated diabetes with 3.6% having chronic kidney disease. Conclusion: The factors of complicated diabetes, cirrhosis, obesity and chronic kidney disease are associated with risk of septicemia in acute cholecystectomy. Key words: Cholecystectomy, Septicemia, Risk factors, Obesity, Chronic kidney disease</jats:p