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Laparoscopic Cholecystectomy : Retrieval of the Gallbladder Specimen and Spilled Gallstones, Inside a Sterile Male Condom as an Endobag, Reduces the Septic Complications

Author: Jawad Kadhim S. AL-Dhahiry
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 2 Pages: 209-215
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: During the course of laparoscopic cholecystectomy .the gallbladder specimen and the spilled stones are retieved by the formal endobag , which is not available in Iraq , or directly through the umbilical or the epigastric port .Direct retrieval of the gallbladder specimen and the spilled stones may cause contamination of the port site . OBJECTIVE : To evaluate the safety,cost effectiveness and incidence rates of intraperitoneal and port site infections when using a sterile male condom as an endobag for retrieval of gallbladder specimen and spilled gallstones .METHODS : This is a prospective study performed in AL-Karama Teaching Hospital, Medical College / Wasit University, Iraq .A total of 306 patients, with symptomatic cholelithiasis underwent Laparoscopic Cholecystectomy (LC), were included in this study performed during the period from April 2011 to June 2014. A sterile male condom was inserted through 10 mm epigastric port. The gallbladder specimen / spilled gallstones of every patient were retrieved inside a sterile male condom. Patients less than 15 years old and those with liver cirrhosis, gallbladder carcinoma and obstructive jaundice, were excluded. The follow-up period ranged from 2 to 42 months.RESULTS:Dissected gallbladders / spilled gallstones of the 306 patients; 279 (91.2%) were females and 27(8.8%) were males with a mean age of 39±12.5 SD (range 16-75) years, were safely retrieved through 10 mm epigastric port inside male condoms. Incidental perforation of gallbladders ,during their dissection from the hepatic bed, was observed11(3.6 %) patients. Perforation of the condom during retrieval of the gallbladder specimens/spilled stones occurred in 12(3.8%) patients.This study had no intraperitoneal nor port site infections. No mortality occurred during the follow-up period.CONCLUSION:Use of a sterile male condom as endobag for retrieval of gallbladder specimen and spilled stones is simple, inexpensive and safe technique. It also reduces the intraperitoneal and port site septic complications .

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