A Study of Port Site Infection after Laproscopic Cholecystectomy at Al-Wahda Hospital Derna Libya

Minimal access surgery has changed the outlook of surgery dramatically. A less painful procedure, Ease of early recovery and return to work along with lesser surgical scar has brought a lot of popularity to laproscopic surgery. Port site infection though occurs in a minority of cases, Butat times becomes a troublesome complication. Despite advances made in the field of antimicrobials, sterilization and surgical techniques as well as operation theatre ventilation, Portsite infection still prevails, Emergence of multidrug resistant strains of rapidly growing atypical mycobacteria has added to the problem of portsite infections, Portsite infections are preventable when appropriate care is taken preoperative, intraoperative and postoperatively. A non surgical approach is effective in most of the cases. Early identification of the condition and appropriate treatment with Macrolides, Quinolones and Aminoglycosides, use of contaminated water to clean the instruments before immersion into glutaraldehyde solution seeding at the port site due to tuberculosis of gall bladder can be some of the causes, The other causes include traumatic injuries associated with access and manipulation, Laproscopic instruments and diathermy injuries. The present study was conducted at Al Wahda Hospital Derna from July 2017 to December 2018. Hundred and Sixteen patients with twenty five males and ninety one females were included in the present study. Details of patient identity, age, sex, preoperative workup including baseline investigations, preoperative sonography findings, intraoperative spillage of stones and bile were recorded. Nine of the patients had spillage of bile and gall stones, of these patients five developed portsite infection. Most common causative organisms were found to be Staphylococcus. Seven out of the nine patients who had spillage of bile were having multiple gall stones and two had single stones. Of the five cases with portsite infection, One was male and four were females. It was found that three patients had portsite infection without intraoperative spillage while two others had portsite infection with spillage of bile and gall stones. In conclusion around 8% of patients will have spillage of bile and stones, The incidence of portsiteinfection is nearly the same in both the cases.