Factors Associated with Port-Site Infection Following Laparoscopic Cholecystectomy

Background: Laparoscopic surgery (LS), also termed minimal access surgery, has brought a paradigm shift in the approach to modern surgical care. Port-site infection (PSI), although less frequently occurs, but it is one of the bothersome complications which may fade the benefits of Laparoscopic cholecystectomy (LC). The present study undertaken to find out the factors associated with it. Materials& Methods: This prospective observational study was conducted in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from July 2019 to January 2021. A total of 150 patients of any age and either sex who underwent laparoscopic cholecystectomy were consecutively included. Demographic characteristics, clinical conditions, and operative variables were considered independent variables, while PSI within 30 days after surgery was the outcome variable. Data were analyzed using descriptive and inferential statistical methods. Result: In the present study, over three-quarters (77%) of the patients were (31 – 40 years old) and female’s outnumbered males by 3:2. Majority (65%) of the patients had chronic cholecystitis and 35% had acute cholecystitis. Risk factors or co-morbidities present among the study subjects were smoking (29%), diabetes (20%), hypertension (12%), obesity 20% and malnutrition 5%. Among the co-morbidities diabetes mellitus was more significant factor to the development of PSI that is four patient was infected out of 11 patients. Acute cholecystitis, spillage of bile’s/stones act as significant determinants of PSI. The duration of operation was observed to be significantly longer in the patients that is more than 60 minutes who developed PSI than that in patients who did not develop. Swabs taken from the port-sites of every patients were subjected to culture; of them 11(7%) exhibited growth (4 Gram +ve and 7Gram -ve). Conclusion: The co-morbidities or risk factors (diabetes, hypertension, smoking, obesity and malnutrition) contributed to the development of PSI. Acute cholecystitis, spillage of bile’s/stones and duration of operation are the significant determinants of PSI.