Laparascopic Cholecystectomy at Wazir Akber Khan Hospital,

Report from a Single Center

Dr.R.Satari M.DSpecialist of General Surgery

Wazir Akber Khan Hospital, Kabul Afghanistan

Background/Aims

• Minimal Invasive Surgery(Last three decades)• Laparascopic Surgery (Recent years)• Laparascopic Cholecystectomy (LC) first

performed in 1985• Introduction of LC into general practice in

1990 it has rapidly become the dominant procedure for GB Surgery

Background/Aims Con…

• Recent three decades, Afghanistan has faced to internal wars and stranger invasions

• Mojaheden regimen, the Taliban and recently bombing and suicide attacks have made the country unsafe and unstable

Background/Aims Con…

• We couldn’t follow the pace of development in the world of medical advances influence of wars low economic loss of relationships with foreign countries

• Our relationships with foreign countries become more and better, people get familiar with new technology (2001)

Background/Aims Con…

• Before 2001, there was no any expert surgeon in Laparascopy

• After that, Laparascopy was introduced in few centers

• Wazir Akber Khan Hospital was the first governmental hospital in 2010 that could proceed to the Laparascopy

Background/Aims Con…

• Laparoscopic cholecystectomy is a recent entry in the treatment of gall bladder disease in Afghanistan mainly in hospitals of the capital city, Kabul, and is slowly gaining acceptance

• Our aim for this study was to review and evaluate our experience of LC at Wazir Akber Khan Hospital in, Afghanistan.

Material and Methods

• Retrospective study• Over one 31 months period ( May 2010 to

November 2013)• 101 patients underwent Laparascopic

Cholecystectomy• All the patients carrying lithiasis symptomatic

profited from this new technique in the general surgery department of WAKH, Kabul, Afghanistan

Results

Gender of patients (n=101)

Sex No of patients %

Male 3 2.9%

Female 98 98.1%

Results con…

Age of patients (n=101)

Age No of PATIENTS %

˂ 20 Years 1 0.9

21-40 years 75 75.2

41-60 years 22 21.7

˃ 60 years 3 2.8

Results con…Complications ( n=101)

Complication No of cases %

Billiary leak 0 0

Bowel injury 0 0

Port site infection 2 1.9

Vascular injury 0 0

Conversion to open surgery

2 1.9

CBD injury 0 0

Mortality 0 0

Results con…

Duration of operation act (Minutes)

Max Min Average

110 48 79

Average of hospital stay (Day)

Max Min Average

4.4 1 2.2

Conclusion

Laparoscopic cholecystectomy is a safe surgical procedure with better outcomes and favorable results for patients. Proper preoperative work up, knowledge of possible complications, and adequate training make this operation a safe procedure with satisfactory results and less complications in a developing and war-torn country like Afghanistan.