LAPAROSCOPIC CHOLECYSTECTOMY: A STUDY OF DEMOGRAPHIC, MORPHOLOGICAL FACTORS AND IATROGENIC OCCURRENCES

Abstract

Objective: To compare the morbid anatomy and iatrogenic problems and complications encountered during laparoscopic cholecystectomy (LC) in both genders.

Study Design: A cross sectional analytical study.

Place and Duration of Study: The study was conducted at Pakistan Air Force Hospital, Islamabad, from May 2017 to Jan 2019.

Methodology: All patients who underwent LC during our study period were included in the study. A predesigned proforma was used to record data. The cases were divided into two groups based on gender. The parameters studied for each group included appearance of gallbladder, intra operative bile leakage, requirement of hemostatic procedure, spillage of stones, multiplicity of stones i.e. single vs. multiple, operative time and need of drain placement.

Results: A total of 120 patients were included in the study. There were 21 (17.5%) male and 99 (82.5%) female subjects. The mean age was 43.66 ± 13.8 years with range of 11-74 years. Normal looking gallbladder was more common in females. Thick walled gallbladder was less frequent in females (males 66.7% vs. females 39.4% p=0.043) Intraoperative complications were more in males. There was no statistically significance gender difference in number of stones, spillage of stones and need for hemostasis.

Conclusion: Symptomatic gallstones were mostly found in females. Gender differences exist as regards the apparent morphology & difficult operative factors. Performance of LC in our setup is of a standard comparable to those of other centers. Since morbid anatomy of females is more favorable, so surgeons new to LC should be encouraged to perform surgery on female patients.