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LAPAROSCOPIC CHOLECYSTECTOMY

NARSAIAH .B M.S, FAIS, FICS. H. I. L. S. CONTACT. ADITYA HOSPITAL. OPP: ANDRA SARASWATI PARISHAD, ... PATIENTS WITH SUSPECTED AND CONFIRMED STONES (CBD) WERE TAKEN. ...

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LAPAROSCOPIC CHOLECYSTECTOMY

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    Slide 1:LAPAROSCOPIC CHOLECYSTECTOMY AND CHOLEDOCHOLITHOTOMY

    PRESENTED BY DR. NARSAIAH .B M.S, FAIS, FICS H I L S CONTACT ADITYA HOSPITAL OPP: ANDRA SARASWATI PARISHAD, TILAK ROAD, ABIDS, HYD. Ph: 4752988, 4754153. ? HYDERABAD INSTITUTE OF LAPAROENDOSCOPIC SURGERY A b c d f

    Slide 2:PATIENTS WITH SUSPECTED AND CONFIRMED STONES (CBD) WERE TAKEN. ALL PATIENTS HAD DILATED CBD . STONES ARE LARGE (AND) OR MULTIPLE. FAILED ERCP AND EXTRACTION OF STONES. ALL SUSPECTED CASES OF MALIGNANCY EXCLUDED FROM STUDY. FITNESS FOR GENERAL ANAESTHESIA.

    H I L S A b c d f PATIENT SELECTION

    H I L S CENSUS 25 TOTAL NO. OF PATIENTS NO 22 YES 3 NO 2 YES 23 BIOCHEMICAL US EXAMINATION A b c d f

    Slide 4:L.C & C INSTRUMENTATION

    ROUTINE VIDEO LAPAROSCOPIC EQUIPMENT. 30 DEGREE TELESCOPE. RIGID URETROSCOPE, CYSTOSCOPE, AND ACCESSORIES. C-ARM FACILITY H I L S A b c d f

    Slide 5:L.C & C PROCEDURE

    POSITION, PORTS, PROCEDURE LIKE LAP CHOLECYSTECTOMY. ADDITION PORT IN EPIGASTRIUM. DISSECTION, ISOLATION AND LIGATION OF CYSTIC DUCT. PER OP CHOLANGIOGARAM PASSING CATHETER THROUGH CYSTIC DUCT. CHOLEDOCHOSCOPY VIA CYSTIC DUCT OR CHOLEDOCHOTOMY. T-TUBE INSERTION AND CLOSURE. H I L S A b c d f

    Slide 6:L.C & C OPERATION DETAILS

    OPERATION TIME 1 TO 3 HRS. BLOOD TRANSFUSION NIL. MORTALITY NIL. MORBIDITY NIL. NO RECURRENT OR RETAINED STONES ON TWO YEAR FOLLOWUP. H I L S A b c d f

    H I L S COMPARISON ERCP + LAP.CHOLE L.C & C TWO OR MORE DIFFICULT ONE TWO ONE MORE LESS OR NIL POSSIBLE DIVIDED NOT DIVIDED COMMON NIL A b c d f H I L S A b c d d L.C & C CONCLUSION H I L S LAPAROSCOPIC CHOLECYSTECTOMY AND CHOLEDOCHOLITHOTOMY IS BETTER ALTERNATIVE MANAGEMENT OF C.B.D STONE OVER ERCP AND CHOLECYSTECTOMY, AND WITH GOOD EXPERTISE IN LAPAROSCOPIC SURGERY IT EVOVLES AS STANDERD PROCEDURE. THANK YOU A b c d f H I L S A b c d fhhhhhhhhhhhhhhhh
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