Comparison of Outcome Between Conventional Laparoscopic Cholecystectomy vs Augmented Single Hole Laparoscopic Cholecystectomy (ASCHOLE)

Zafar Ali Choudry; Muhammad Saleem Iqbal; Muhammad  Latif; Burhan ul Haq; Muhammad Faisal Bilal Lodhi; Muhammad Salman Zafar

doi:10.29054/apmc/2019.270

Zafar Ali Choudry Vice Chancellor & Professor of Surgery, Faisalabad Medical University Faisalabad Pakistan
Muhammad Saleem Iqbal Assistant Professor Surgery, Faisalabad Medical University / Allied Hospital, Faisalabad Pakistan
Muhammad Latif Assistant Professor of Surgery, Khawaja Muhammad Safdar Medical College Sialkot
Burhan ul Haq Senior Registrar of Surgery, Allama Iqbal Medical College Lahore Pakistan
Muhammad Faisal Bilal Lodhi Professor of Surgery, Faisalabad Medical University / Allied Hospital, Faisalabad Pakistan
Muhammad Salman Zafar Ex-House Officer, Jinnah Hospital, Lahore Pakistan

DOI: https://doi.org/10.29054/apmc/2019.270

Keywords: ASHCHOLE, Conventional cholecystectomy, Postoperative pain, Better outcome

Abstract

Introduction: Laparoscopic cholecystectomy is the mainstay treatment for symptomatic gallstones. In conventional or standard laparoscopic cholecystectomy four ports (two of 10-mm diameter and two of 5-mm diameter) are usually used. An innovative assisted single whole laparoscopic cholecystectomy procedure using low profile cannulas is designed to contemplate this procedure to reduce cost and have better cosmetic results especially in young females. Objective: To compare the outcome between conventional laparoscopic Cholecystectomy vs Augmented Single Hole Laparoscopic Cholecystectomy (ASCHOLE). Study Design: Randomized controlled trial. Setting: Surgical unit-III Allama Iqbal medical college Lahore, Department of Surgery, Khawaja Muhammad Safdar Medical College Sialkot. Duration: 3 years from January 2016 to December 2018. Sample Size: 100 cases (50 in each group). Sampling Technique: Non-probability Purposive Sampling Technique. Results: A total of 100 cases (50 in each group) were enrolled for this study. Group-A patients who underwent ASHCHOLE and Group-B conventional laparoscopic cholecystectomy. Regarding age distribution of the patients majority of the patients in both groups were recorded between 31-40 years of age i.e. 38%(n = 19) in Group-A and 34%(n = 17) in Group-B, 28%(n = 14) in Group-A and 22%(n = ll) in Group-B were between 20-30 years, 22%(n = ll) in Group-A and 28%(n = 14) in Group-B were between 41-50 years while 12%(n = 6) in Group-A and 16%(n=8) in Group-B were between 51-60 years, mean and SD was calculated as 38.43±4.21 years in Group-A and 39.65±511 in Group-B. Gender distribution of the patients show 42 %( n = 21) in Group-A and 36 %( n = 18) in Group-B were male while 58 %( n = 29) in Group-A and 64 %( n = 32) in Group-B were females. Comparison of mean operative time in both groups reveals 50.89±13.42 minutes in Group-A and 34.55±6.17 in Group-B, p value was < 0.005. Comparison of mean pain score in both groups revealed 3.14±0.76 in Group-A and 6.13±1.21 in Group-B, p value was < 0.005. Conclusion: The results of the study revealed that ASCHOLE is safe technique having less postoperative pain and single fine scar hidden in umbilicus than conventional laparoscopic cholecystectomy.