Presentation Of Post Cholecystectomy Bile Duct Injuries In A Tertiary Care Hospital

Introduction:The occurrence of iatrogenic bile duct injuries is few, however potentially linked to life-threatening complications, particularly following the advent of laparoscopic cholecystectomy. Aims &Objectives: To evaluate the presentation of post-cholecystectomy bile duct injuries in a tertiary care hospital. Place and Duration of Study: This study was done in the Department of General Surgery at Combined Military Hospital Rawalpindi from Nov 2020 to Dec 2021. Material &Methods: This cross-sectional study was conducted on 15 subjects with post-cholecystectomy bile duct injuries.All the patients who presented to the emergency department and outdoor were included in the study and had post-cholecystectomy CBD injuries. Laparoscopic and open BDI were classified according to Strasberg classification. In descriptive statistics, mean, and standard deviation was used, and in qualitative analysis, frequency and percentages were calculated with the help of the SPSS 23 version, a p-value of? 0.05 was considered significant. Results: In our study, 5 (33.3 %) males and 10 (66.7 %) were females, with a mean age of 47.27 ± 4.79. The presentation on the admission of patients was as follows, 3 (20.0 %) patients had biloma, 4 (26.7 %) had jaundice, 2 (13.3 %) had abdominal pain, 1 (6.7 %) had external biliary fistula, 3 (20.0 %) had Biliary peritonitis and 2 (13.3 %) had a fever. Conclusion: The most common consequence of cholecystectomy was complete resolution, but bile leak and major duct damage cause considerable morbidity, death, and healthcare expenditures. Better outcome was achieved when a nonprimary and skilled hepatobiliary surgeon repaired severe bile duct damage

Postoperative Complications in Carcinoma Gall Bladder: A Tertiary Care Hospital Experience

Introduction: Gallbladder cancer is more common than any other part of the biliary system. Accounting between 2% and 3% of all cholecystectomies. Aims &Objectives: To analyze different postoperative complications in various stages of operated gall bladder carcinoma. Place and duration of study: Army Liver Transplant Unit (A.L.T.U.) Pak Emirates Military Hospital Rawalpindi (P.E.M.H.), from November 2020 to April 2022. Material & Methods: This cross-sectional descriptive study looked at all patients diagnosed with gallbladder cancer before surgery or who were subsequently found to have benign gallbladder cancer presenting with intra-luminal lesions and localized or diffuse wall thickening amenable to surgical treatment. A sequential sampling method was used to select the patients. A proforma was developed to streamline the data collection process. The patient's gallbladder cancer was staged using the A.J.C.C.'s Eighth Edition staging system, and the degree of complications was classified using the Clavien-Dindo system. Data was entered and analysed using SPSS version 23. Results: A total of 27 patients were included in the study, with male to female ratio of 1:3; and a mean age of 50.1 ± 4.7 years (range 25-70 years). Six patients were in Stage-1 of whom only 1 (3.7%) developed grade – I complication; 9 patients were in Stage-2, out of which 2 (7.4%) developed grade – II complications; 6 patients were in Stage-3, out of which 2 (7.4%) patients developed grade – III and 1 (4.7%) patient developed grade-II postoperative complications. Six (22.2%) were in Stage-4 and underwent curative resection, where no patient developed postoperative complications. Conclusion: Surgery remains a solitary curative option for gall bladder carcinoma, and when patients are selected carefully, postoperative complications after radical surgery are not very high. Moreover, as the stage of the disease increases, so does the complication grade