1. Head of Surgical Hospital General Surgery Resident
Outcome of Gallbladder Surgery at Al-Shifa Medical Complex ( One Year Experience)
Dr. Marwan Abusada
Head of Surgical Hospital
( Al-Shifa M.C)
Dr. Mohammed Hararah
General Surgery Resident

2. Retrospective study started on 1. 1. 2016 to 31. 12
Retrospective study started on to comparing the outcome of gallbladder surgery at al-shifa medical complex with international standards .

3. Objectives To assess the pattern and the performance of surgical team
To determine the rate of complications among operated cases

4. Methodology Retrospective study
About 380 patients file were reviewed by the surgical team at al-shifa hospital
Different variables included ,age ,gender,length of stay , admission route , cause of admission ,type of surgery , complications , drain usage.

5. Inclusion criteria
All pateints who underwent surgery for isolated gall bladder disease

6. Data were analysed by SPSS version 22

7. About 80 cases admitted to our surgical department due to gallbladder diseases treated conservatively ,but disappeared without follow up later . These cases were excluded from our study .

8. 19 cases were non-operable cases due to advanced stage of tumors as gallbladder tumor or cholangiocarcinoma . The remaining 281 cases were the true cases included in this study .

10. Age

11. Mean age of patient was 43.7y

13. Causes of admission

14. All patient with obstructive jaundice had ERCP before surgery.
One patient had ERCP after surgery due to missed stone in this study .

15. Type of surgery

16. Complication rate

17. complications

18. Average length of stay

19. Drain insertion

20. UpToDate
90 % of cholecystectomies in the United States are performed Laparoscopically Laparoscopic cholecystectomy complications were reported in as many as 5 % of patients.

21. In a study that combined the data from seven large studies with a total of 8856 laparoscopic cholecystectomies , serious complications occurred in 2.6 percent . A combined review of eight large studies of laparoscopic cholecystectomies reported the following types and frequencies of major complications: bleeding (0.11 to 1.97percent), abscess (0.14 to 0.3 percent), bile leak (0.3 to 0.9 percent), biliary injury (0.26 to 0.6 percent) bowel injury (0.14 to 0.35 percent) The rate of wound infections and surgical site infections is lower with the laparoscopic approach than with the open approach, but there is no advantage in terms of intra-­abdominal abscess formation .

22. References
1. Strasberg SM. Biliary injury in laparoscopic surgery: part 1. Processes used in determination of standard of care in misidentification injuries. J Am Coll Surg 2005; 201: Strasberg SM. Biliary injury in laparoscopic surgery: part 2. Changing the culture of cholecystectomy. J AmColl Surg 2005; 201: Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 1995; 180: Thurley PD, Dhingsa R. Laparoscopic cholecystectomy: postoperative imaging. AJR Am J Roentgenol 2008; 191: Biscione FM, Couto RC, Pedrosa TM, Neto MC. Comparison of the risk of surgical site infection after laparoscopic cholecystectomy and open cholecystectomy. Infect Control Hosp Epidemiol 2007; 28:1103

23. Conclusion
The outcome gallbladder surgery at al- shifa medical complex is congruent with international standards in terms of complication rates .
It's recommended to change the policy of drain insertion that cause delay of hospital discharge .
Its recommended to shorten the length of stay .

24. Thank you