Original Articles
Study The Achievement Of Critical View Of Safety In Laparoscopic Cholecystectomy | |
Dr. Raj Kishan, Dr. Shamim Siddiqui, Dr. Divyansh Kaushik, Dr. C. S. Rawat | |
Aim: To study the critical view of safety of Strasberg in laparoscopic cholecystectomy. Materials and methods: This study is a prospective interventional study conducted on patients undergoing elective laparoscopic cholecystectomy at Era’s Lucknow Medical College & Hospital. A total sample size of 60 patients was determined using statistical formulas, considering a 20% loss to follow-up. The inclusion criteria included patients aged 18 years and above, while cases of gallbladder malignancy and choledocholithiasis were excluded. The study employed statistical analysis using SPSS Version 21.0. Various statistical tools were utilized, including mean and standard deviation for descriptive analysis, the paired t-test for comparing changes over time, and the chi-square test for categorical variables. Odds ratio calculations assessed the likelihood of outcomes between groups, while ANOVA determined variance between study groups. The level of significance was set at p < 0.05. This research aims to evaluate the achievability of CVS in different patient profiles and its impact on surgical outcomes, including operative time, postoperative complications, pain levels, and hospital stay duration. Results: A majority of the patients in present study were Females (66.7%), while the remaining were Males (33.3%). Gender ratio of the present study was 2:1. Mean age of the patients included in the study was 39.50±11.66 years and ranged from 21 to 71 years. Majority of the patients were in 3rd to 5th decade of life (61.6%). The mean duration of surgery was 57.37±11.24 minutes and ranged between 39.0 & 78.0 minutes. Blood loss ranged through 20 to 125 ml. Mean Blood loss was 69.75±21.72 ml. Nassar grade of the cases ranged between 1 & 5. Mean grade was 1.85±0.92. The average drain collection was 25.58±10.08 ml and ranged from 5 to 50 ml. Mean post-op pain at 1 hour was 4.45±0.50. At repeated intervals of 2 hour, 4 hour and 24 hour was 3.2±0.65, 2.58±0.36 & 1.18±0.70. Mean hospital stay of the cases was 3.35±0.77 days & it ranged between 2 to 5 days. CVS was achieved in a majority of the cases (73.3%), while it failed to be achieved in 26.7% of the cases. On comparing statistically, no significant association of age with achievement of CVS achievement was found. On comparing statistically, no significant association of gender with achievement of CVS achievement was found. On comparing statistically, intra-operative findings between the cases where CVS was achieved to those in whom CVS achievement failed, though the cases where CVS was not achieved had a longer duration of surgery (58.43±11.89 vs. 54.44±8.90 minutes) and had more Drain collection (25.56±8.70 vs. 25.23±10.62 ml). However, statistically, this difference was not significant. On the other hand, cases in whom CVS was achieved as compared to those where it failed to be achieved a significantly lower Blood Loss (64.09±20.35 vs. 85.31±17.75 ml) and Nassar Grading (1.55±0.79 vs. 2.69±0.70). Though the pain was higher at all post-operative intervals in the cases, where CVS was not achieved, on comparing statistically, no significant association of pain was found at any post-operative interval with achievement at CVS. Though the hospital stay was longer in cases in whom CVS could not be achieved as compared to those where CVS was achieved, however statistically this difference was not significant. Conclusion: No significant association of age and gender was found with achievement of CVS and significantly lower Blood Loss and Nassar Grading was found in cases in whom CVS was achieved. In cases in whom CVS was achieved, there was shorter duration of hospital stay and shorter duration of surgery. Pain at different intervals were similar in patients in whom CVS was achieved and not achieved |
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