Muhammad Bilal Akbar¹*, Sheza² and Babar Hameed³

¹Senior Clinical Fellow, Dr. Grays Hospital, UK. Visiting Consultant, National Hospital and Medical Centre Lahore
²Post Graduate Trainee General Surgery, National Hospital and Medical Centre Lahore
³Consultant Surgeon, National Hospital and Medical Centre Lahore

*Corresponding Author: Muhammad Bilal Akbar, Senior Clinical Fellow, Dr. Grays Hospital, UK. Visiting Consultant, National Hospital and Medical Centre Lahore.

Received: October 31, 2023; Published: November 23, 2023

Abstract

Introduction: Port site infection (PSI) is always a concern for the affected. PSI can result in increase in the morbidity, hospital stay and financial loss to the patient. There are certain risk factors that can result in this infection risk and include Diabetes Mellitus (DM), immunocompromised states such as end stage renal or liver disease, immune suppressive drugs and the burden of the infected collection in the abdomen needing surgery.

Objectives: To determine the frequency of diabetics in patients undergoing laparoscopic cholecystectomy and to compare the frequency of port site infection in diabetic versus non-diabetics undergoing laparoscopic Cholecystectomy.

Study design: Descriptive, case series study.

Study duration: 14th April 2020 to 13th October 2020.

Materials and Methods: A total of 140 cases undergoing laparoscopic cholecystectomy and of ages 20-70 year old were included. Patients with malignancies, sepsis and end stage renal failure were excluded. All patients were optimized before surgery. Then these cases were divided into two equal groups by determining the frequency of DM. All cases were undergone laparoscopic cholecystectomy by a consultant surgeon with at least 1 year or more post fellow ship experience. Then these cases were assessed daily till discharge and were followed up at day 7 and 14.

Results: Age range in this study was from 20 to 70 years with mean age of 41.56 ± 9.11 years. Majority of the patients 95 (67.86%) were between 20 to 45 years of age. Out of 140 patients, 110 (78.57%) were female and 30 (21.43%) were males with male to female ratio 3.7:1. In our study, frequency of diabetics in patients undergoing laparoscopic cholecystectomy was found in 24 (17.14%) patients. Frequency of port site infection in diabetic patients was found in 08 (33.33%) patients versus in 05 (4.31%) non-diabetics undergoing laparoscopic Cholecystectomy.

Conclusion: This study concluded that frequency of diabetics in patients undergoing laparoscopic cholecystectomy was found to be 17.14% with frequency of port site infection in diabetic is significantly high than non-diabetics.

Keywords: Laparoscopic Cholecystectomy; Diabetics; Port Site Infection

References

1. Deng Y., et al. “Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: A meta-analysis based on seven randomized controlled trials”. Surgical Oncology 24 (2015): 71-77.
2. Boni L., et al. “Infective complications in laparoscopic surgery”. Surgical Infections (Larchmt)2 (2006): S109-S111.
3. Owens CD and Stoessel K. “Surgical site infections: epidemiology, microbiology and prevention”. Journal of Hospital Infection 2 (2008): 3-10.
4. Chittawar P., et al. “Minimally invasive surgical techniques versus open myomectomy for uterine fibroids”. Cochrane Database of Systematic Reviews 10 (2014): CD004638.
5. Leblebicioglu H., et al. “Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)”. American Journal of Infection Control 43 (2015): 48-52.
6. Baiu I and Hawn MT. “Gallstones and Biliary Colic”. JAMA15 (2008): 1612.
7. Martin ET., et al. “Diabetes and Risk of Surgical Site Infection: A Systematic Review and Meta-analysis”. Infection Control and Hospital Epidemiology 1 (2016): 88-99.
8. Nakamura T., et al. “Risk factors for surgical site infection after laparoscopic surgery for colon cancer”. Surgical Infections (Larchmt) 4 (2016): 454-458.
9. Ismat U., et al. “Surgical site infection in diabetic and non-diabetic patients undergoing laparoscopic cholecystectomy”. Journal of College of Physicians and Surgeons Pakistan 2 (2016): 100-102.
10. Aziz M., et al. “Comparative Study of Surgical Site Infection in Clean Surgical Procedures between Diabetic and Non-Diabetic Patients”. Medforum 1 (2017): 2-5.
11. Warren DK., et al. “Risk Factors for Surgical Site Infection After Cholecystectomy”. Open Forum Infectious Diseases 2 (2017): ofx036.
12. Hu ASY., et al. “Risk factors for conversion of laparoscopic cholecystectomy to open surgery-A systematic literature review of 30 studies”. The American Journal of Surgery 5 (2017): 920-930.
13. Mannino M., et al. “Open conversion for laparoscopically difficult cholecystectomy is still a valid solution with unsolved aspects”. World Journal of Emergency Surgery 1 (2019): 1-4.
14. Lim JU., et al. “Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients”. International Journal of Chronic Obstructive Pulmonary Disease 12 (2017): 2465-2475.
15. Lala V., et al. “Liver Function Tests. Treasure Island (FL): StatPearls Publishing (2020).
16. Bali R., et al. “To Compare the Efficacy of C-Reactive Protein and Total Leucocyte Count as Markers for Monitoring the Course of Odontogenic Space Infections”. Journal of Maxillofacial and Oral Surgery 3 (2017): 322-327.
17. Arora V., et al. “Hyperbilirubinemia in normal healthy donors”. Asian Journal of Transfusion Science 2 (2009): 70-72.
18. National Institutes of Health (NIH). “Gallstones and Laparoscopic Cholecystectomy”. NIH Consensus Statement. NIH (1992): 14-16.
19. Shea JA., et al. “Indications for and outcomes of cholecystectomy: a comparison of the pre and postlaparoscopic eras”. Annals of Surgery 3 (1998): 343-350.
20. Nealon WH., et al. “Appropriate timing of cholecystectomy in patients who present with moderate to severe gallstone-associated acute pancreatitis with peripancreatic fluid collections”. Annals of Surgery 6 (2004): 741-749.
21. Lillemoe KD., et al. “Laparoscopic cholecystectomy as a "true" outpatient procedure: initial experience in 130 consecutive patients”. Journal of Gastrointestinal Surgery 1 (1999): 44-49.

Citation

Citation: Muhammad Bilal Akbar., et al. “To Determine the Frequency of Diabetics and Compare the Frequency of Port Site Infection in Diabetic Versus Non-Diabetics in Patients Undergoing Laparoscopic Cholecystectomy".Acta Scientific Gastrointestinal Disorders 6.12 (2023): 47-53.

Copyright

Copyright: © 2023 Muhammad Bilal Akbar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.