Methods
This cohort study was carried out at the Department of Surgery, Liaquat University Hospital, Hyderabad/Jamshoro, Pakistan, over a period of two years from March 2010 to February 2012. The study was designed in compliance with the Helsinki Declaration and a formal approval for the study was obtained from the institutional Ethics Review Committee (ERC), Liaquat University of Medical & Health Sciences.
The study consisted of 220 patients with acute or chronic cholecystitis secondary to gallstones admitted through the outpatient Department. Non-probability convenient sampling technique was used. Written, informed consent was taken from all the participants and/or their next of kin where so applied.
Patients with evidence of carcinoma gallbladder, on clinical grounds and confirmed on ultrasonography and/or CT scan were excluded. Gallbladders showing gross abnormalities suggestive of localized or infiltrative malignancy during surgery were excluded. Detailed history and thorough clinical examination of the patients was done with special attention to the right hypochondrium for preoperative assessment of palpable mass. Systemic review was done to see any co-morbidity. Baseline and specific investigations especially ultrasonography of abdomen was done in all patients. Laparoscopic cholecystectomy was performed in all cases but had to be converted to open procedure in few cases where anatomical distortion and dense adhesions prevented any further progress laparoscopically. All gallbladder specimens, including those with no obvious gross abnormality, were sent for histopathology.
A predesigned proforma was used to put down the information gathered. Data were analyzed using SPSS version 17.0.