Laparoscopic Cholecystectomy: An Experience in Combined Military Hospital, Rangpur

Background: Laparoscopic surgery (LC) has gained popularity quickly due to its many
benefits over traditional open surgery. The reduction in postoperative
pain had a positive impact on humans, as did the shorter hospital stay
and earlier return to work. Nevertheless, this procedure has various
per-operative and postoperative complications that cannot be ignored,
despite being a minimally invasive technique

Objective:The aim was to evaluate the intraoperative, postoperative complications
of laparoscopic cholecystectomy (LC); the rate of conversion to open
cholecystectomy and the reasons for it; the length of the hospital stay
following the procedure; and the operating time.

Methods:This retrospective study included 245 individuals who had laparoscopic
cholecystectomy performed between July 2022 and June 2024 at
Department of Surgery,Combined Military Hospital (CMH), Rangpur.
Retrospective analysis was done on patient medical records. Armed
Forces persons and their family members who are entitled to have
medical treatment facilities were included in this study.

Results: Out of 245 participants, 211(86.12%) were females and 34(13.88%) males. The average age of the male and female patients was 40.13 and 39.20 years respectively.Most prevalent age group was between 3rd and 4th decade in both sexes. Hypertension (HTN) (6.12%), diabetes mellitus (DM) (6.12%), and HTN & DM, together (6.12%) were most commonly associated comorbidities. 180(73.47%) patients showed normal anatomy of gall bladder (GB) per-operatively. 39(15.92%) patients had major and minor intra operative complications while 14(5.71%) patients had postoperative complications. 12(4.90%) conversion open cholecystectomy was done in that series due to different reasons. In 126 cases (51.53%) operating time was <40 minutes and 119 cases (48.57%) that was >40 minutes and in most cases (86.12%) post operative hospital stay was <48 hours.

Conclusions: About one-third of PWE needed to be more compliant with their
medication. If the treatment of PWE is restricted to monotherapy as far
as possible and they are educated about the duration of therapy and
possible adverse effects of AEDs, non-adherence may be reduced.

Conclusion:LC brought a new range of complications. Right patient selection and
timely bailout decision for difficult LC may reduce mortality and
morbidity in a non-tertiary care hospital.