Incidence of Superficial Port Site Infection in Laparoscopic Cholecystectomy in relation to Spilt Stone and Bile Spillage
Abstract
Introduction: Laparoscopic cholecystectomy is the choice of operation
for symptomatic gallstones. Gallstone and bile spillage can occur during
laparoscopic cholecystectomy during dissection by cautery or due to
perforation of gall bladder by grasper. The complication of spilt stone and
bile may range from simple superficial surgical site infection, adhesion,
obstruction, abscess formation to none.
Methods: This study was conducted
at Western Regional Hospital (WRH), Pokhara from July 2015 to December
2016. A total of one hundred and twenty patients who underwent laparoscopic
cholecystectomy were included. All patients’ age, sex, pre-operative
ultrasound findings, intra operative spillage of stone and bile and post-
operative superficial surgical site infection were noted. Statistical analysis
was done using Microsoft Excel software and SPSS-21. Result obtained
from the study was discussed with reference to current world literature.
Results: Out of one hundred and twenty patients, one hundred and nine
were female and eleven were male with mean age of 42.68 years. Spillage
of stones and bile occurred in twelve patients (10%). Spillage of stone and
bile was common with multiple stones. Only four patients (one male and
three females) developed superficial port site infection (3.3%). Two patients
among spillage and two among non spillage developed superficial surgical
site infection (p<0.05). Most common organism was Staphylococcus aureus
followed by Escherichia coli.
Conclusion: The incidence of split stone or bile
is 10 % and is common with multiple gallstones. The chance of superficial
surgical site infection is more in male patients and with spillage of stone and
bile.