Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study
Introduction: The most effective treatment for gallstone disease symptoms is Laparoscopic Cholecystectomy (LC). Gallbladder retrieval is a crucial step, with direct extraction and endobag-assisted extraction being commonly used techniques. Direct extraction may lead to increased bile spillage and po...
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JCDR Research and Publications Private Limited
2025-08-01
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| Online Access: | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=August&volume=19&issue=8&page=PC12-PC15&id=21325 |
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| author | Swathy Elangovan K Vivekananda Subramania Nathan R Sivamarieswaran M Reegan Jose |
| author_facet | Swathy Elangovan K Vivekananda Subramania Nathan R Sivamarieswaran M Reegan Jose |
| author_sort | Swathy Elangovan |
| collection | DOAJ |
| description | Introduction: The most effective treatment for gallstone disease symptoms is Laparoscopic Cholecystectomy (LC). Gallbladder retrieval is a crucial step, with direct extraction and endobag-assisted extraction being commonly used techniques. Direct extraction may lead to increased bile spillage and port-site infections, whereas the endobag provides protection against contamination but may increase operative time.
Aim: To compare the outcomes of direct gallbladder extraction versus endobag-assisted extraction in LC, focusing on bile spillage, port-site infections, operative time, postoperative pain and hospital stay duration.
Materials and Methods: This prospective observational study was conducted in the Department of General Surgery, SRM Medical College Hospital and Research Institute, Kattankulathur, Chengalpattu, Tamil Nadu, India, from December 2024 to March 2025. A total of 60 patients undergoing elective LC were randomised into two groups: Group A (direct extraction) and Group B (endobag extraction). Primary outcomes included intraoperative complications (gallbladder perforation and bile spillage) and postoperative complications (port-site infections and pain levels). Secondary outcomes assessed operative time and hospital stay duration. Continuous variables were expressed as means with standard deviations, and categorical variables as frequency counts and percentages. An independent t-test was used for comparing continuous variables and the Chi-square test for categorical data. A p-value <0.05 was considered statistically significant.
Results: The mean age of subjects in Group A was 38.1±13.9 years {males: 16 (53.3%), females: 14 (46.7%)}, and in Group B, it was 44.3±12.5 years {males: 13 (43.3%), females: 17 (56.7%)}. The endobag group (Group B) had significantly lower rates of bile spillage (6.7% vs. 23.3%, p-value=0.036) and port-site infections (3.3% vs. 16.7%, p-value=0.019) compared to direct extraction (Group A). Group B also demonstrated significantly shorter operative times (32.2±3.7 minutes vs. 39.1±5.4 minutes, p-value <0.001) and hospital stay durations (1.5±0.5 days vs. 2.2±0.8 days, p-value <0.001). Postoperative pain scores on the 1st day (5.4±1.3) and 3rd day (2.2±0.8) were significantly lower in Group B (p-value <0.001).
Conclusion: Endobag-assisted gallbladder extraction significantly reduces bile spillage, port-site infections, and postoperative pain while decreasing the duration of hospital stay. It is a safer alternative to direct extraction, particularly in high-risk patients. |
| format | Article |
| id | doaj-art-d0a9ba3a01b24dd9975098dcd4259e28 |
| institution | DOAJ |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | JCDR Research and Publications Private Limited |
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| spelling | doaj-art-d0a9ba3a01b24dd9975098dcd4259e282025-08-20T02:57:17ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-08-01198PC12PC1510.7860/JCDR/2025/79293.21325Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational StudySwathy Elangovan0K Vivekananda Subramania Nathan1R Sivamarieswaran2M Reegan Jose3Postgraduate, Department of General Surgery, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India.Professor, Department of General Surgery, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India.Associate Professor, Department of General Surgery, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India.Assistant Professor, Department of General Surgery, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India.Introduction: The most effective treatment for gallstone disease symptoms is Laparoscopic Cholecystectomy (LC). Gallbladder retrieval is a crucial step, with direct extraction and endobag-assisted extraction being commonly used techniques. Direct extraction may lead to increased bile spillage and port-site infections, whereas the endobag provides protection against contamination but may increase operative time. Aim: To compare the outcomes of direct gallbladder extraction versus endobag-assisted extraction in LC, focusing on bile spillage, port-site infections, operative time, postoperative pain and hospital stay duration. Materials and Methods: This prospective observational study was conducted in the Department of General Surgery, SRM Medical College Hospital and Research Institute, Kattankulathur, Chengalpattu, Tamil Nadu, India, from December 2024 to March 2025. A total of 60 patients undergoing elective LC were randomised into two groups: Group A (direct extraction) and Group B (endobag extraction). Primary outcomes included intraoperative complications (gallbladder perforation and bile spillage) and postoperative complications (port-site infections and pain levels). Secondary outcomes assessed operative time and hospital stay duration. Continuous variables were expressed as means with standard deviations, and categorical variables as frequency counts and percentages. An independent t-test was used for comparing continuous variables and the Chi-square test for categorical data. A p-value <0.05 was considered statistically significant. Results: The mean age of subjects in Group A was 38.1±13.9 years {males: 16 (53.3%), females: 14 (46.7%)}, and in Group B, it was 44.3±12.5 years {males: 13 (43.3%), females: 17 (56.7%)}. The endobag group (Group B) had significantly lower rates of bile spillage (6.7% vs. 23.3%, p-value=0.036) and port-site infections (3.3% vs. 16.7%, p-value=0.019) compared to direct extraction (Group A). Group B also demonstrated significantly shorter operative times (32.2±3.7 minutes vs. 39.1±5.4 minutes, p-value <0.001) and hospital stay durations (1.5±0.5 days vs. 2.2±0.8 days, p-value <0.001). Postoperative pain scores on the 1st day (5.4±1.3) and 3rd day (2.2±0.8) were significantly lower in Group B (p-value <0.001). Conclusion: Endobag-assisted gallbladder extraction significantly reduces bile spillage, port-site infections, and postoperative pain while decreasing the duration of hospital stay. It is a safer alternative to direct extraction, particularly in high-risk patients.https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=August&volume=19&issue=8&page=PC12-PC15&id=21325bile spillagegallbladder perforationport-site infection |
| spellingShingle | Swathy Elangovan K Vivekananda Subramania Nathan R Sivamarieswaran M Reegan Jose Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study Journal of Clinical and Diagnostic Research bile spillage gallbladder perforation port-site infection |
| title | Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study |
| title_full | Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study |
| title_fullStr | Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study |
| title_full_unstemmed | Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study |
| title_short | Direct Gallbladder Extraction versus Endobag Extraction during Laparoscopic Cholecystectomy: A Prospective Observational Study |
| title_sort | direct gallbladder extraction versus endobag extraction during laparoscopic cholecystectomy a prospective observational study |
| topic | bile spillage gallbladder perforation port-site infection |
| url | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=August&volume=19&issue=8&page=PC12-PC15&id=21325 |
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