Benefits and Complications of Extraction of Gall Bladder using a Drain Bag Vs Direct Extraction after Laproscopic Surgery

Abstract

Introduction: Laparoscopic cholecystectomy as the gold standard for gallbladder removal due to its benefits of decreased postoperative discomfort and scarring, but notes the risks associated with bile and stone spillage during surgery, such as abscesses and fistulas. While retrieval devices mitigate these risks, they can complicate extraction and increase the chance of organ damage.

Materials and methods: The study compares gallbladder extraction complications using an endobag versus direct extraction through a 10mm epigastric port, focusing on port site infection and intraoperative spillage. Group A (50 patients) used a retrieval bag made from a simple polythene drain cover for specimen removal, while Group B (50 patients) had specimens directly removed through the 10mm epigastric port.

Results: The mean intraoperative time for Group A with endobag extraction was 69±3.5 minutes, slightly longer than Group B (66±4.62 minutes). Port site infection occurred in 6% of Group A patients and 24% of Group B patients. Bile or stone spillage during retrieval was noted in 4% of Group A and 10% of Group B patients. Epigastric incision enlargement occurred in 4% of cases (n=4); three cases were in Group A and one in Group B. There were no instances of port site hernia in either group.

Conclusion: Laparoscopic cholecystectomy remains the preferred treatment for cholelithiasis due to its effectiveness and reduced complications. While using an endobag is recommended to minimize surgical site infections (SSI), it may prolong operative time and pose a risk of bowel injury. Nonetheless, the use of endobags significantly reduces the incidence of port site infections compared to direct extraction, underscoring its value in preventing complications during gallbladder removal.