A 6-year Prospective Clinical Study of Laparoscopic Cholecystectomies in Kashmir Valley, India
Keywords:Laparoscopic cholecystectomy, rural health, developing countries, health care costs
Objective: To evaluate the feasibility of reducing hospital stay length and the cost of laparoscopic cholecystectomies (LCs) in a developing country.
Study Design: A clinical study of patients with symptomatic cholelithiasis undergoing an LC in Gousia Hospital, District Hospital Baramulla, Modern Hospital, and Ahmed Hospital of Kashmir from January 2001 to March 2007. The main parameters evaluated were mortality, conversion, complications, re-operation, reduction in hospital stay length, and cost.
Results: One thousand, three hundred, and thirty-five patients, 1024 females and 311 males, presented for LCs. There was no mortality in the 30 postoperative days. Twenty-five cases were converted to open procedures, while one patient had common bile duct (CBD) injury. No long-term complications were noted.
Conclusion: An LC can be performed safely in small hospitals in a developing country, provided equipment is available, and the operating team members are well trained. The overall cost can be minimized by using reusable instruments, intracorporeal sutures, and self-made specimen extraction bags.
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