Effectiveness on Laparoscopic Cholecystectomy with Intraoperative Gallbladder Drainage for Patients with Acute Calculous Cholecystitis, Kalasin Hospital

Abstract

The purpose of this prospective analytic cohort research was to study the effectiveness of laparoscopic surgery in patients with acute calculous cholecystitis, kalasin hospital, The 113 acute calculous cholecystitis patients’ medical records were selected between May 2019 to June 2020, were divided into experimental and control groups, by inclusion criteria, patients were taken gallbladder puncture during surgery (Intraoperative gallbladder drainage) and not taken gallbladder puncture. Indication of gallbladder drainage is marked distension gallbladder without gangrenous or necrotic tissue. Exclusion criteria was open gallbladder surgery patients. The research instrument was a patient's medical record data recording, consisting of 3 parts: basic patient information, Effectiveness on laparoscopic cholecystectomy and complication is infection rate. The research instrument that recording document was validated by 3 experts and reliability with the use of test records and repeated testing. (test-retest) were equal to .94, .96, .98 and .96 respectively. The data was analyzed using computer software using percentage, mean, standard deviation, and Independent t – test. The findings as follows;

1.The basic data of the samples were that most of both groups were female 65.06%, 53.33%, and Average aged of both groups was 54.47%, At the most age group of operative pattern that was taken gallbladder puncture 60 – 69, and the most age group of operative pattern that was not taken gallbladder puncture 50 – 59 and 60 – 69.            

2.The effectiveness of both groups that the complications from surgery was found the pain score is low (M = 1.87, SD = 0.99) and the estimated of blood loss between and after surgery an average of 22.04 milliliters (SD = 3.51), 3.12 days in hospital (SD = 0.33). An average expenditure budgets of all average was 24,781 baht, that An average expenditure budgets of operative pattern that was taken group was 22,985.86 baht, and an average expenditure budgets of operative pattern that was not taken gallbladder puncture group was 29,750.69 baht. The last, the mean of operative time of both groups were 28.91 minutes., for operative pattern that was taken group was 25.52 minutes., that for operative pattern that was not taken group was 38.30 minutes.              

3. Complication was  the mean of infection rate of 0.04% (SD = 0.21)

4.The mean of operative time, pain score, expenditure budgets of patients were taken gallbladder puncture before surgery had better than and the patients who were not taken gallbladder at the statistically significant .05, but hospital length stay, the estimated of blood loss, infection rate, re-admission rate are not different.

Recommendations from this research of the effectiveness on laparoscopic surgery in patients with acute calculous cholecystitis who were taken intraoperative gallbladder puncture before cholecystectomy shows which low of operative time, pain score, less of hospital length, reduced for medical care cost, although there are additional expenses for surgical instruments and equipment. Should be promote or support the application of this type of surgery for patients who require surgical treatment as possible as.