FREQUENCY AND COMMON RISK FACTORS IN UMBILICAL PORT SITE INFECTION IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

INTRODUCTION roscopic cholecystectomy (LC) provides a safe and
effective treatment of most patients with symptomatic
ABSTRACT
Introduction: Wound infection remains the major problem in surgical practice worldwide. Historically the wound
infection can be disastrous in terms of morbidity and mortality just by ignoring the aseptic techniques. In less than
three decades no other operation has been so profoundly affected by the advent of laparoscopy as cholecystectomy.
A National Institute of Health [NIH] consensus statement in 1992 stated that “Laparoscopic cholecystectomy (LC)
provides a safe and effective treatment of most patients with symptomatic Gall Stones and has become the treatment
of choice for many patients.
Objective: To determine the frequency and common risk factors in umbilical port infection in patients undergoing
elective Laparoscopic cholecystectomy.
Material and Methods: This study was conducted at Department of Surgery, Surgical B Unit, Khyber Teaching Hospital,
Peshawar. Duration of the study was one year (23/03/2015 to 22/3/2016) in which a total of 166 patients were observed.
All patients undergoing for elective laparoscopic cholecystectomy, Both gender, Age between 18- 60 and patients with
Cholelithiasis with echogenic foci in the gallbladder on ultrasound were included. All the admitted patients underwent
complete history taking and clinical examination, and baseline investigations as a part of pre-operative work-up was
done. Patients were asked to stop oral intake after 12 midnight on the night of surgery. Third generation cephalospo-
rin (cefoperazone plus sulbactam) was given to all patients at the time of induction of anesthesia. All patients were
scrubbed with pyodine for 3 minutes, with special emphasis on umbilicus. Three to four ports were inserted according
to surgeon’s preference. All the technical aspects of the procedure were kept standardized amongst all patients. Patient
wound was checked on day 5 after surgery and was asked for followup after five days for removal of stitches and the
wound assessment for signs of infection in the form of local erythema, tenderness and discharge.
Results: In this study Mean age was 48 years with SD ± 18.66. Twenty six percent patients were male while 74% pa-
tients were female. Seventeen 10% patients had port site infection in which 14(82%) patients had BMI >30, 12(68%)
patients had prolonged surgery > 200 minutes, 70% patients were operated by junior consultants and 13(75%) patients
had acute cholecystitis.
Conclusion: Our study concludes that the incidence of umbilical port infection in patients undergoing elective Lap-
aroscopic cholecystectomy was 17(10%) and the main risk factors were obesity, prolonged surgical procedures,
procedures done by junior consultants.
Key Words: Common risk factors, umbilical port infection, elective Laparoscopic cholecystectomy.