BILE DUCT INJURIES; DETERMINE THE FREQUENCY DURING OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY AT TERTIARY CARE HOSPITALS

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Objectives: Determine the frequency of bile duct injuries during open andlaparoscopic cholecystectomy procedures. Study Design: Prospective Observational Study.Place and Duration of Study: This study was conducted at surgical department of multiplehospitals and compares the results Civil Hospital Naushahro Feroze, Liaquat University HospitalJamshoro and Civil Hospital Karachi and NaushahroFeroze, August 2014 to December 2015.Methods: All 320 patients were equally divided for open cholecystectomy and Laparoscopiccholecystectomy. Demographic profile and detailed Clinical examination were recorded. Allpatients were evaluated for Cholelithiasis underwent preoperative investigations. All patientswere resuscitated and optimized before intervention. Inclusion criteria were diagnosed caseof gallstones, age > 20 years and both gender selected for open cholecystectomy andLaparoscopic cholecystectomy and assessed the frequency of bile duct injury during bothprocedures. Exclusion criteria were of carcinoma of gall bladder, stone in CBD and obstructivejaundice. Chi square test was applied for p-value. Results: 320 cases of gallstone wereundertaken for operative laparoscopic cholecystectomy and open cholecystectomy procedure.Most of the patients were 208(65%) female, male to female ratio were 1:7.2. Gall stonecommonly reported in 3rd and 4th decade 186(58.13%) cases in between 36-50 years. The meanage was 39.8+5.90years. Abdominal ultrasound revealed that multiple stone 253(79.1%) casesas compared to single stone. Other common findings of thick wall gallbladder139 (43.44%)cases while ultrasonologist reported impacted gallbladder stone in 23(7.19%) cases. Commonbile duct injury more occur in open procedure 24(7.5%) cases as compared to laparoscopiccholecystectomy 15 (4.7%) cases and Chi square test was applied for p-value <0.001.Conclusion: The Laparoscopic procedure has decreased rate of complications and bile ductinjury day by day due to improved learning curve.

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