Complications of laparoscopic cholecystectomy

ABSTRACT Objective: The main objective was to determine the complications of laparoscopic cholecystectomy (LC) and its causes at Isra University Hospital, Hyderabad. Methodology: This was a retrospective study carried out from July 2005 to June 2007. Data of all patients undergoing laparoscopic cholecystectomy during the study period and fulfilling the selection criteria was collected and analyzed retrospectively. Results: A total of 216 patients underwent laparoscopic cholecystectomy with an overwhelming majority of females. The overall complication rate was 5%. The complications included bleeding (4/216, 1.8%) from cystic artery and gall bladder bed, port site infection (4/216, 1.8%), bile duct injury (2/216, 0.9%) and colonic injury (1/216, 0.4%). The common causes of these complications were accidental injury to cystic artery, gross spillage of infected bile and erroneous clipping of common bile duct. Conclusions: Bleeding and Port site infections were the commonest complications followed by common bile duct and colonic injuries. The commonest cause of bleeding was cystic artery injury whereas the commonest cause of port site infection was gross spillage of infected bile

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Abstract We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure