LETTER TO EDITOR
|Year : 2007 | Volume
| Issue : 4 | Page : 178
Empyema gall bladder and laparoscopic cholecystectomy
Iqbal Saleem Mir
Post Graduate Department of Surgery, Govt Medical College, Srinagar, Kashmir, India
|Date of Submission||10-Oct-2007|
|Date of Acceptance||11-Oct-2007|
Iqbal Saleem Mir
Post Graduate Department of Surgery, Govt Medical College, Srinagar, Kashmir
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mir IS. Empyema gall bladder and laparoscopic cholecystectomy. J Min Access Surg 2007;3:178
I read the article about laparoscopic management of empyema gall bladder  with interest. Some points documented underneath need clarification as the authors have not given the details.
How was the gall bladder extracted? Was an extraction bag used?
The role of analysis by SPSS version 10 has not been further elucidated anywhere in the text. What variable was being assessed?
In the exclusion criteria did the authors exclude patients with bleeding disorders?
The USG findings discussed are non-specific and usually it is quite difficult to predict empyema gall bladder with these findings. We have found out that a thick-walled gall bladder >4 mm with a stuck stone at the neck is more of a predictor of empyema than other findings mentioned. Even the clinical features are sometimes misleading.
In table 3A the number of CBD injuries shown is 3 while as in the discussion repair of only two cases is documented. Which one is correct?
After conversion what were the results? Was cholecystectomy completed in all patients?
What is the role of intraoperative cholangiography in such cases?
What is the role of laparoscopic cholecystostomy in empyema gallbladder? Would it have decreased the overall conversion and the complication rates?
Did the very high morbidity documented justify the early intervention in pre-surgery documented cases of empyema?
| ¤ References|| |
|1.||Malik A, Laghari AA, Talpur KA, Memon A, Mallah Q, Memon JM. Laparoscopic cholecystectomy in empyema of gall bladder: An experience at Liaquat University Hospital, Jamshoro, Pakistan. J Min Access Surg 2007;3:52-6. |