A comparative study of laparoscopic cholecystectomy with and without abdominal drain

Background: Laparoscopic surgery has several advantages when compared to open surgery, including faster post-operative recovery and lower pain scores. Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Routine drainage after laparoscopic cholecystectomy is an issue of considerable debate.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sub hepatic fluid collection on first ultrasound at 24hrs was higher in drained group than in non-drained groups. Further, the difference became insignificant on subsequent ultrasound at 72hrs. Incidence of post-operative drain site pain was present in 25% of patients with drain (more at drain site). Incidence drain site infection was present in 16.6% of patients in drain group. Majority of the patients with drain group (n=24) required hospital stay for ≥3 days, while for majority of patients without drain group (n=20), required hospital stay was 1 day.Conclusions: An uncomplicated gall stone disease can be treated by laparoscopic cholecystectomy without need for drain with reasonable safety by an experienced surgeon. With no usage of drain, it is significantly advantageous in terms of post-operative pain, use of analgesics and hospital stay

Role of triple assessment modalities in diagnosis of palpable breast lump

Background: One fourth of women suffer from breast disease in their lifetime. Carcinoma of breast is the second most common cancer in the world. Timely and accurate diagnosis of breast lump with early intervention can be life saving. There are various modalities for the diagnosis of breast lump such as USG, FNAC and Mammography, MRI etc. but none of them is perfect. There are numerous reports suggesting that if the results of clinical assessment, mammography and FNAC are all combined, the diagnostic accuracy is nearly 100%. Furthermore, these techniques also provide information about tumor size, number, extent and grade preoperatively.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sensitivity, specificity and accuracy of triple test in present study were 98.68%, 87.5%, and 96% respectively. Out of 100, 76 patients were confirmed as having benign lesion and 24 patients having malignant lesion by histopathology examination.Conclusions: Results of triple assessment are same as the results by histopathology examination in majority of cases. It is highly accurate, can be used as a confirmatory diagnostic tool for breast lump, thus there is no need to perform diagnostic open biopsy for breast lump