An Observational Study on Port-site Infection and its Management in Patients Undergoing Laparoscopic Cholecystectomy

Kamalika Ghosh, Sandip Kumar Ghosh, Priyabrata Shit, Ajay Halder
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Abstract

Background: With increasing number of performed laparoscopic cholecystectomies, there is an increasing number ,of port site infection, although it occurs infrequently, but it has significant influence on overall outcomes of laparoscopic cholecystectomy. The aims of the present study was to identify the causative organism involved in port-site infection (PSI) and its management and outcome after laparoscopic cholecystectomy objectives and to evaluate causative organism involved in port site infection after laparoscopic cholecystectomy.Materials & Methods: Patients who underwent laparoscopic cholecystectomy and now presenting with PSIin General Surgery OPD and Emergency of Burdwan Medical College and Hospital. Thorough clinical historytaking followed by swabs was taken for culture and sensitivity in all patients who developed port site infection after laparoscopic cholecystectomy. Tissue samples were taken for detection of mycobacterium tuberculosis by CBNAAT. All patients were followed up for 6 months post operatively. Incidence of PSI in relation to gender, pre-operative diagnosis, spillage, relation with different port sites and the type of microorganism associated was evaluated and compared with previous study.Results: In the present study 90 patients who underwent laparoscopic cholecystectomy, 19 patients reported port site infection after surgery, whereas the remaining 71 patients had uneventful post operative period. Out of the 19 infected 7 were male [25% of total male cases] and 12 were female [19% of total female cases]. Cases of port site infection were 21% of total cases. Conclusion: The incidence of PSI was higher in cases of acutely inflamed GB, biliary spillage, open port creation, avoidance of endo-bag, and in comorbidities. They were managed with either antibiotics, dressing or surgical exploration.
关于腹腔镜胆囊切除术患者孔口感染及其处理的观察研究
背景:随着腹腔镜胆囊切除术的数量不断增加,端口部位感染的数量也在不断增加,虽然这种感染并不经常发生,但它对腹腔镜胆囊切除术的整体效果有重大影响。本研究旨在确定腹腔镜胆囊切除术后端口部位感染(PSI)的致病菌及其处理方法和结果,并评估腹腔镜胆囊切除术后端口部位感染的致病菌:接受腹腔镜胆囊切除术并在 Burdwan 医学院和医院的普通外科手术室和急诊中出现 PSI 的患者。对所有在腹腔镜胆囊切除术后发生端口部位感染的患者进行彻底的临床病史采集,然后进行拭子培养和药敏试验。组织样本通过 CBNAAT 检测结核分枝杆菌。所有患者在术后均接受了 6 个月的随访。评估了 PSI 的发生率与性别、术前诊断、溢液、不同手术部位的关系以及相关微生物的类型,并与之前的研究进行了比较:结果:在本研究的 90 名接受腹腔镜胆囊切除术的患者中,有 19 名患者在术后报告了端口部位感染,而其余 71 名患者术后均无大碍。在 19 例感染病例中,7 例为男性(占男性病例总数的 25%),12 例为女性(占女性病例总数的 19%)。端口部位感染病例占病例总数的 21%。结论:在急性胃肠道炎症、胆汁溢出、开放式造口、避免使用内衬袋以及合并症的病例中,PSI 的发生率较高。这些病例要么使用抗生素、敷料,要么进行手术探查。
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