Port Site Infection in Laparoscopic Cholecystectomy: A Prospective Observational Study at a Tertiary Care Hospital in India.

Abstract

Background: Laparoscopic surgery, a minimally invasive technique, is preferred due to its rapid recovery and minimal incisions. However, postsurgery port site infection (PSI) is a rare complication that can increase patient morbidity and damage the surgeon's reputation. The effectiveness of laparoscopic surgery depends on advancements in sterilization and surgical techniques. This current study aimed to evaluate the port site infections after laparoscopic cholecystectomy, identify contributing variables, and ascertain which factors are amenable to modification to avoid infections and optimize the benefits of laparoscopic surgery, thereby improving patient outcomes.

Methodology: This prospective observational study, including 138 participants having elective laparoscopic cholecystectomy, was done over 1 year, from January 1 to December 31, 2021, at a tertiary care hospital.

Results: We observed the port site infection rate in 6 of 138 participants (4.3%). Male patients showed increased rates, with infections occurring in three of 13 (23%, χ² =0.218; P = 0.641) cases when bile, stones, or pus spilled, and in 4 of 6 (66.7%, χ² =012.105; P = 0.001, a significant association) cases at the epigastric port. The majority of the port site infection (PSI) were superficial, accounting for 83.3%, with nonspecific bacteria identified in 5 out of 6 cases (83.3%).

Conclusion: The majority of PSIs were superficial and more common in males; one participant experienced a mycobacterial infection; there is a significant association between port site infection and pus, stones, or bile spilling through the port used for gallbladder extraction. Chronic deep surgical site infections require special consideration because Mycobacterium tuberculosis may be the cause.