Objective: to evaluate the safety of ultrasonic (harmonic) dissection during laparoscopic cholecystectomy in terms of gall bladder perforation.
Methodology: This descriptive study was conducted at surgical B unit of Lady Reading Hospital Peshawar from July 2007 to December 2008, on 120 patients with symptomatic gallstones. Patients fulfilling the study criteria, were selected on consecutive non-probability sampling technique. All the patients were operated laproscopicaly through standard four-port technique. Ultrasonic device (harmonic) was used for GB dissection off its bed. Intraoperatively bile leak or stone spillage was looked for suggesting GB perforation. The demographic and clinical (intraoperative) data of the all the patients were recorded in a proforma and data was analyzed with SPSS version-16.
Results: The age of the patients ranged from 18 to 70 years with the maximum number in the 4th decade. The mean age was 40.15±12.632 years. The male to female ratio was 1: 6.66. The mean hospital stay was 3.37±0.766 days. Patients with gall bladder perforation were 20 (16.7%) and 16.6% of the gall bladder perforation occurred in 21 to 50 years of age. The gall bladder perforation in male and female were 8.3% and 8.3% respectively.
Conclusion: Ultrasonic dissection of gall bladder from its bed is a safe technique and carried 16.7% risk of all bladder perforation. In resources limited countries, proper training of laparoscopic surgery should be encouraged.
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