Abstract Issue

Volume 13 Issue 5 (May) 2024

Original Articles

A prospective study of incidence, classification and laparoscopic management of cystic duct stones in a tertiary care teaching hospital
Dr. Shreya Bhardwaj, Dr. Krishnanand, Dr. Deepak Shukla, Dr. Shivamchaudhary, Dr. Tanmay Samuel

Background: The cystic duct, which connects the gallbladder to the common hepatic duct, is a tortuous channel susceptible to obstruction by cystic duct stones (CDS). Hence; the present study was conducted for assessing the incidence, classification and laparoscopic management of cystic duct stones in a tertiary care teaching hospital. Materials &methods:A prospective study was carried out for 60 patients one year from may 2022 to may 2023 by a single surgeon and his team. All the patients were subjected to laparoscopic cholecystectomy using standard 4- port technique after documentation of GB calculi using ultrasonography for diagnosis.The whole series of patients were followed for a period 6months-1 year with history & clinical examination and USG & LFTs whenever need felt.All cases of symptomatic gall stone disease plan for laparoscopic cholecystectomy, whichare having cystic duct stone detected intraoperatively of this study.Patients with cholelithiasis with CBD stone, Mirizzi syndrome and patients in whom subtotal cholecystectomy was done and cases which needed conversion into open cholecystectomy exclude of this study. All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis using SPSS software. Results:We performed 60 laparoscopic cholecystectomy from may 2022 to may 2023. Out of them, 60% were female and 40% were males. 50% were between the age group of 40-50 years, 20% were between 30-40 years and 10% were between 50-60 years and 6% were less than 30 years and 14% more than 60 years old. We have 2 cases of sickle cell, a 28 year female and 21year old male and one case 23 year old female with PCOD. 60% of patients were operated on for symptomatic cholelithiasis, whereas 30% were operated for Acute cholecystitis. We found cystic duct stones in 10% patients having impacted stones with proximal duct stones in 2patients, distal stones in 2 patients, 1 patient had stones in the middle part of the cystic duct and 1 patients are having freely mobile stones . LFT was normal in all of the cases. Preexisting mild pain was there in all of the cases. Conclusion: One important cause of PCS is the underreporting and underestimation of CD stone occurrence. Let us assume, however, that during a laparoscopic cholecystectomy, careful attention is paid to CD and that certain simple and safe manoeuvresare utilized.

 
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