Abstract :
Background: Cholelithiasis, the leading cause for hospital admissions related to gastrointestinal problems, had been
traditionally dealt by open cholecystectomy. Erich Muhe performed the first laparoscopic cholecystectomy on
September 12, 1985. In September 1992, a National Institute of Health (NIH) consensus conference held in Bethesda
concluded that laparoscopic cholecystectomy should be the treatment of choice for gallstone disease. This study on
laparoscopic cholecystectomy was done to illustrate the clinical manifestations and peroperative findings in gallstone
disease. Methods: We prospectively studied 100 consecutive cases undergoing laparoscopic cholecystectomy at our
institute. Presenting complaints, laboratory investigations and USG findings were noted. Standard 4-port laparoscopic
cholecystectomy was performed, with closed method using Veress needle preferred for the first (umbilical) port. All
peroperative findings were analyzed. Results: Majority of the patients were female (79%), and the average age of the
patients was 40.18 years. Pain in upper abdomen was the most common presenting complaint (93%) and an
association with meal was found in 85%. Peroperatively, multiple calculi were found in 77%, with impaction of calculus
at neck seen in 10% of the patients. Distended gall bladder was seen in 19%, and mucocele in 3%. Shrunken gall
bladder was observed in 4%. Difficult Calot’s triangle, due to adhesions, was found in 22%. Biliary tree or vascular
anomaly was seen in 8%. Mean postoperative hospital stay was 1.92 days. Conclusion: Pain abdomen in gallstone
disease is commonly seen in association with meals. Thick-walled gall bladder, adhesions at Calot’s triangle, and
distended gall bladder are common peroperative findings.
Keyword :
Laparoscopic, cholecystectomy.