Laparoscopic Cholecystectomy in a tertiary care teaching hospital-retrospective study

Laparoscopic Cholecystectomy in a tertiary care teaching hospital-retrospective study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Laparoscopic Cholecystectomy in a tertiary care teaching hospital-retrospective study Abdirahman Ahmed Mohamud, Jafar Abdullahi Omar, Salim İdris Keleşoğlu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1680188/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The most common surgical procedure for the digestive tract is laparoscopic cholecystectomy. It has replaced open cholecystectomy as the gold standard treatment for gallbladder inflammation and cholelithiasis. In Somalia, it is estimated that over 90% of cholecystectomies are performed laparoscopically. The goal of this study was to assess the result of laparoscopic cholecystectomy in terms of complications, conversion rate, and length of stay at a tertiary care hospital. Methods This retrospective analysis was conducted on 564 patients who had laparoscopic cholecystectomies at Mogadishu Somali Turkey Training and Research Hospital between January 2018 and January 2022, and the essential data is collected and analyzed. Results A total of 564 patients were studied in this study, with 99 men (18%) and 465 females (82 percent ). The patients ranged in age from 20 to 90, with a mean age of 45. In our study, the operative time ranged from 15 to 90 minutes. The conversion rate was 4.4%. Six patients had bile duct injuries (1.0 percent ). Conclusions Gallstone disease is increasingly international. Laparoscopic cholecystectomy has replaced open cholecystectomy as the preferred gallstone treatment. Most gallstone patients are female. Male gender, thick adhesions in Calot's triangle, advanced age, Acute cholecystitis, dense adhesions, and fibrosis, and less surgeon experience increase the likelihood of an open cholecystectomy. Cholecystectomy Laparoscopic Cholecystectomy Complications Associated with Cholecystectomy Introduction Cholecystectomy is a common abdominal surgery, and many are laparoscopic in developed countries. For example, 90% of cholecystectomies in the US are laparoscopic [1]. Laparoscopic cholecystectomy is the "gold standard" for gallstone surgery. This technique reduces pain, improves cosmesis, shortens hospital stays, and reduces work impairment [2–8]. Laparoscopic cholecystectomy has a greater complication risk than open surgery. The indications Include symptomatic cholelithiasis, Asymptomatic cholelithiasis in patients at risk for gallstones or gallbladder cancer. acalculous Cholecystitis, Polyps > 0.5cm, porcelain gallbladder. Contraindications include diffuse peritonitis with hemodynamic compromise and uncontrolled hemorrhage [11]. Intraoperative complications like Vascular injury, intestine perforation, mesenteric injury, and bile duct injuries require prompt laparotomy. Laparoscopic surgery should be switched to open if the surgeon needs manual palpation and direct visualization. If necessary, surgeons should perform open surgeries. The gallbladder hole can be closed with forceps or sutured to avoid additional spilling. Suction and irrigate the bile. Bile spilling without stone spillage does not aggravate postoperative infections [11]. Gallstones, especially pigment stones, which harbor germs, can increase postoperative infection risk [12–17]. If possible, extract any discharged gallstones. This task requires large stone graspers. If a trocar impales a major blood vessel, it should be left in place and a laparotomy performed immediately. Trocars should be seen with the laparoscope when removed to check for lacerated abdominal wall vessels. Bleeding can be managed via cautery, Foley catheter balloon tamponade, or a figure-of-eight stitch. Observe and mark bowel damage throughout and after the case. If there is leakage, it can be fixed laparoscopically or openly by extending the umbilical incision. Laparoscopic surgery can then start. Bile duct damage should be corrected immediately. Indocyanine green fluorescence imaging could describe biliary anatomy and avoid bile duct damage. The technique isn't proven, but it seems promising [16,17]. Some bile duct injuries aren't identified during surgery and manifest later. All should be referred to an experienced biliary surgeon because the initial procedure has the best probability of success. If the surgeon is elsewhere, the patient should be externally drained. The goal of this study is to share our experience with LC problems, which have a morbidity rate of about 1.4 percent when performed in teaching hospital, yet major LC complications can be handled by skilled surgeons. Materials And Methods This retrospective study included 564 patients who had laparoscopic cholecystectomies at Mogadishu Somali Turkey Training and Research Hospital from January 2018 to January 2022. The following data was retrospectively reviewed: patient demographics (age, gender), preoperative investigations (CBC, bleeding-coagulation times, liver function tests, renal function tests, blood glucose level, screening for hepatitis), intra-operative findings (duration of operation, intra-operative bleeding and iatrogenic injuries), conversion from laparoscopic to open cholecystectomy and reason for conversion, postoperative complications (hemorrhagic complications). The study excluded patients with incomplete files. Four-port laparoscopic cholecystectomies were performed. Three months of care follows surgery. Ethical Statement Local ethical committee accepted study protocol (Mogadishu Somali Turkey Training and Research Hospital). Results In the course of our research, a total of 564 patients were evaluated, with 465 females (82 percent) and 99 men (18 percent) . The number of females to males was 9 to 2. The gender distribution is presented in Table 2 . The majority of the patients were in the age range of 20 to 29 years old (22.5 percent), followed by the age range of 40 to 49 years old (20 percent ). 45 years was the average age of all of the patients. ( Table 1) . In the course of our study, the average amount of time spent in operation was 48 minutes, with a range of 15–90 minutes. The operational time is showed in Table 5 . 25 out of 564 individuals required an open cholecystectomy as a result of the initial operation (4.4 percent ). Table 7 shows laparoscopic cholecystectomies which were Converted to open cholecystectomy. The rationale behind the conversion is detailed in Table 3 . In the course of our research, we discovered that there were a total of two duodenal injuries and six significant bile duct injuries. The two injuries to the duodenum were treated with primary repair, while the injuries to the bile duct were transferred to a hepatobiliary center for further evaluation. During the operation, 121 patients experienced gallbladder perforation; however, none of these patients went on to develop intraabdominal sepsis. The difficulties are outlined in Table 4 . 103 patients, or 18.3 percent, had their operations in the morning and were discharged the following morning. The average length of time spent in the hospital following surgery was 70 hours (range: 24-120). The length of time hospital stays is detailed in Table 6. Discussion Laparoscopic cholecystectomy (LC) is the surgery of choice in modern medicine for treating gallstone disease with symptoms. The LC treatment was initially recommended for patients with simple cholelithiasis at our facility. LC, on the other hand, was made available for patients with acute calcular cholecystitis when the additional experience was gained. The age and gender distributions seen in our study were similar to those observed in previous findings (18). The average operating duration in our study was 48 minutes, which is less than the 70-90 minute range reported in other studies (18-20). This was most likely due to our case selection policy. Eighteen percent of our patients were discharged home without difficulties or readmissions on the first postoperative day. The conversion rate was 4.4 percent. This is in line with the results of other studies (22-27). The most common causes of conversion in our study were dense adhesion and fibrotic gallbladder. Bleeding is one of the most well-known cholecystectomy side effects. Clinically severe bleeding was noted in 0.5 percent of LC patients (17). Three patients in our series experienced bleeding, necessitating an open cholecystectomy. Because of dense adhesion (13), fibrotic gallbladder (6), bleeding (3), and acute inflamatory adhesion in three of the patients, 25 patients had their surgeries converted to open cholecystectomies (0.5 percent ). Laparoscopic cholecystectomy (LC) is technically more difficult when dealing with acute cholecystitis than when dealing with elective cases. Due to significant inflammation and increased adhesion, the anatomy around the calot's triangle is obscured, making dissection difficult and potentially dangerous. Conversion should not be viewed as a complication in these instances; rather, it should be viewed as an endeavor to resolve concerns through greater surgical procedures (28). Laparoscopic cholecystectomy (LC) has a number of advantages over open cholecystectomy, but it comes with its own set of risks (29). The risk of biliary tract damage with the laparoscopic technique ranges from 0.2 percent to 0.9 percent. This is a particular source of concern (31-35). The relatively high rate of bile duct injury that can occur during laparoscopic cholecystectomy (LC) is considered by many surgeons to be the procedure's principal problem. Injury to the bile duct is associated with a high rate of morbidity, as well as prolonged hospitalization, a higher financial burden, the risk of legal action, and, in some cases, even death (24). On the other side, as more surgeons gain experience, the incidence of this complication is likely to decrease (30). For five days, two patients had bile flowing through the drain in a continuous . The laparotomy that was conducted to repair the duodenal injury was successful. Gallbladder perforation during surgery occurred in 121 cases, accounting for 21.4 percent of the total. This is in contrast to the incidence, which has been estimated to be between 10% and 32%. (25). The dissection of the gallbladder bed, the retraction of the gallbladder, the removal of the gallbladder from the liver, and the sliding of cystic duct clips are the most prevalent causes of bile spilling. Conclusion The fact that the rates of complications and overall conversion rate fall within acceptable limits demonstrates that laparoscopic coblation (LC) is a safe minimally invasive method. Our results were in line with the findings of the previous studies. However, When there is a complication, a multidisciplinary approach is required. The procedure should be carried out in a high-volume hospital. because it would be beneficial in terms of mortality morbidity. Abbreviations LC Laparoscopic Cholecystectomy CBC Complete Blood Count Declarations Ethics approval and consent to participate This study was reviewed and approved by the Ethical Committee of Mogadishu Somali Turkish Training and Research Hospital (Date:21.02.2022 , Decision No. 493, Ref. MSTH/9200), due to retrospective design, informed consent was not obtained by the ethics committee rule. Consent for publication Not Applicable. Availability of data and materials The data is available from the corresponding author and can be accessed if requested. Competing interests We declare that we have any no competing of interest. Funding We declare that we have no funding source. Authors’ contributions A. A.M: brought the idea of the study, performed data collection, prepared the manuscript, and final revision. J. A.O: participated in the data Analysis. All authors read and approved the manuscript before submitting. Acknowledgements Not Applicable. References Csikesz NG, Singla A, Murphy MM, et al. Surgeon volume metrics in laparoscopic cholecystectomy. Dig Dis Sci 2010; 55:2398. Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new 'gold standard'? Arch Surg 1992; 127:917. Schirmer BD, Edge SB, Dix J, et al. Laparoscopic cholecystectomy. Treatment of choice for symptomatic cholelithiasis. Ann Surg 1991; 213:665. Wiesen SM, Unger SW, Barkin JS, et al. Laparoscopic cholecystectomy: the procedure of choice for acute cholecystitis. Am J Gastroenterol 1993; 88:334. Wilson RG, Macintyre IM, Nixon SJ, et al. Laparoscopic cholecystectomy as a safe and effective treatment for severe acute cholecystitis. BMJ 1992; 305:394. Rattner DW, Ferguson C, Warshaw AL. Factors associated with successful laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 1993; 217:233. Johansson M, Thune A, Nelvin L, et al. Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis. Br J Surg 2005; 92:44. Yamashita Y, Takada T, Kawarada Y, et al. Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14:91. Keus F, Broeders IA, van Laarhoven CJ. Gallstone disease: Surgical aspects of symptomatic cholecystolithiasis and acute cholecystitis. Best Pract Res Clin Gastroenterol 2006; 20:1031. Steinert R, Nestler G, Sagynaliev E, et al. Laparoscopic cholecystectomy and gallbladder cancer. J Surg Oncol 2006; 93:682. Jones DB, Dunnegan DL, Soper NJ. The influence of intraoperative gallbladder perforation on long-term outcome after laparoscopic cholecystectomy. Surg Endosc 1995; 9:977. Deziel DJ, Millikan KW, Economou SG, et al. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 1993; 165:9. Carlin CB, Kent RB Jr, Laws HL. Spilled gallstones--complications of abdominal-wall abscesses. Case report and review of the literature. Surg Endosc 1995; 9:341. Horton M, Florence MG. Unusual abscess patterns following dropped gallstones during laparoscopic cholecystectomy. Am J Surg 1998; 175:375. Zamir G, Lyass S, Pertsemlidis D, Katz B. The fate of the dropped gallstones during laparoscopic cholecystectomy. Surg Endosc 1999; 13:68. Ishizawa T, Bandai Y, Kokudo N. Fluorescent cholangiography using indocyanine green for laparoscopic cholecystectomy: an initial experience. Arch Surg 2009; 144:381. Pertsemlidis D, Barzilai A, Persemlidis DS, et al. Enhanced laparoscopic visualization of the extrahepatic bile duct with intravenous indocyanine green [abstract]. Am J Gastroenterol 1993; 88:1583. Vagenas K, Karamanakos SN, Spyropoulos C, Panagiotopoulos S, Karanikolas M, Stavropoulos M. Laparoscopic cholecystectomy: a report from a single center. World Journal of Gastroenterology: WJG. 2006 Jun 28;12(24):3887. Shrestha S, Pradhan G, Bhoomi K, Dhital A, Bhattachan CL. Review of laparoscopic cholecystectomy in Nepal Medical College Teaching Hospital. Nepal Medical College Journal. 2007 Mar 1;9:1. Lim SH, Salleh I, Poh BK, Tay KH. Laparoscopic cholecystectomy: an audit of our training programme. ANZ journal of surgery. 2005 Apr;75(4):231-3. Merdad AM. Laparoscopic cholecystectomy: Rate and predictors for conversion. Saudi Journal of Gastroenterology. 1999 Sep 1;5(3):117. Keulemans Y, Eshuis J, de Haes H, de Wit LT, Gouma DJ. Laparoscopic cholecystectomy: day-care versus clinical observation. Annals of Surgery. 1998 Dec;228(6):734. Baird DR, Wilson JP, Mason EM, Duncan TD, Evans JS, Luke JP, Ruben DM, Lucas GW. An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital. The American surgeon. 1992 Mar 1;58(3):206-10. Wherry DC, Marohn MR, Malanoski MP, Hetz SP, Rich NM. An external audit of laparoscopic cholecystectomy in the steady state performed in medical treatment facilities of the Department of Defense. Annals of surgery. 1996 Aug;224(2):145. Hadad SM, Vaidya JS, Baker L, Koh HC, Heron TP, Thompson AM. Delay from symptom onset increases the conversion rate in laparoscopic cholecystectomy for acute cholecystitis. World journal of surgery. 2007 Jun;31(6):1300-3. Lichten JB, Reid JJ, Zahalsky MP, Friedman RL. Laparoscopic cholecystectomy in the new millennium. Surgical endoscopy. 2001 Aug;15(8):867-72. Kaushik R, Sharma R, Batra R, Yadav TD, Attri AK, Kaushik SP. Laparoscopic cholecystectomy: an Indian experience of 1233 cases. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2002 Feb 1;12(1):21-5. Lim K, Ibrahim S, Tan N, Lim S, Tay K. Risk factors for conversion to open surgery in patients with acute cholecystitis undergoing interval laparoscopic cholecystectomy. ANNALS-ACADEMY OF MEDICINE SINGAPORE. 2007 Aug 1;36(8):631. Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses. Journal of British Surgery. 1994 Sep;81(9):1362-5. Dunn D, Nair R, Fowler S, McCloy R. Laparoscopic cholecystectomy in England and Wales: results of an audit by the Royal College of Surgeons of England. Annals of the Royal college of Surgeons of England. 1994 Jul;76(4):269. Soper NJ, Dunnegan DL. Laparoscopic cholecystectomy: experience of a single surgeon. World journal of surgery. 1993 Jan;17(1):16-20. Deveney KE. The early experience with laparoscopic cholecystectomy in Oregon. Archives of Surgery. 1993 Jun 1;128(6):627-32. Club SS. A prospective analysis of 1518 laparoscopic cholecystectomies. The New England Journal of Medicine. 1991 Apr 18;324(16):1073-8. Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, Schwartz JS, Williams SV. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Annals of surgery. 1996 Nov;224(5):609. Terpstra OT. Laparoscopic cholecystectomy: the other side of the coin. BMJ. 1996 Jun 1;312(7043):1375-6. tables Table 1: Age distribution of the patients Age group (in years Frequency Percentage % 20-29 127 22.5 30-39 105 18.6 40-49 113 20.0 50-59 89 15.8 60-69 77 13.7 70-79 41 7.3 >=80 12 2.1 Total 564 100.0 Table 2: Gender distribution of the patients Gender Frequency Percentage Male 99 18 Female 465 82 Total 564 100.0 Table 3: Reasons For Conversion Reasons For Conversion Frequency (%) Dense Adhesion 13(2.3%) Fibrotic Gallbladder 6(1%) Intraoperative Bleeding 3(0.5%) Acute Inflammatory adhesion 3(0.5%) Total 25(4.4% ) Table 4: post-operative complications of LC complications of LC Frequency (%) Bile duct injury 6(1.0%) Duodenal Injury 2(0.40%) Gallbladder perforation 121(21.4%) Intra operative bleeding 65(11.6%) Total 194(34.4%) Table 5: Operative time of LC Operative time Frequency Percentage 15-30 min 285 50.5 30-60 min 250 44.3 > 60 min 29 5.1 Table 6: Hospital stay Hospital stay Frequency Percentage 24Hour 103 18.3 2 day 399 70.7 >2days 62 11 Table 7: Conversion to Open Conversion to Open Frequency Percentage No 539 95.6 Yes 25 4.4 Total 564 100.0 Additional Declarations No competing interests reported. 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Also discoverable on Platform About In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1680188","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":114430734,"identity":"0b084d4c-cd1e-4484-8871-6754038daa39","order_by":0,"name":"Abdirahman Ahmed Mohamud","email":"data:image/png;base64,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","orcid":"","institution":"Department General Surgey, Mogadishu Somali Turkey Training and Research Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Abdirahman","middleName":"Ahmed","lastName":"Mohamud","suffix":""},{"id":114430735,"identity":"689bede5-280a-4033-9db6-dd5c0de8b018","order_by":1,"name":"Jafar Abdullahi Omar","email":"","orcid":"","institution":"Lecturer at Aden Adde international University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jafar","middleName":"Abdullahi","lastName":"Omar","suffix":""},{"id":114430736,"identity":"e268a41b-1f3d-4ad7-b9a4-8efa0b19d37a","order_by":2,"name":"Salim İdris Keleşoğlu","email":"","orcid":"","institution":"İzmir Tepecik Training And Research Hospital, Izmir-Turkey.","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Salim","middleName":"İdris","lastName":"Keleşoğlu","suffix":""}],"badges":[],"createdAt":"2022-05-21 16:59:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1680188/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1680188/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":22966399,"identity":"25c6ee95-2b2f-4ffb-a2a4-1d8b1b368307","added_by":"auto","created_at":"2022-06-22 19:52:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":329568,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1680188/v1/0900c031-0f99-40fb-b1fc-28751f237388.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Laparoscopic Cholecystectomy in a tertiary care teaching hospital-retrospective study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCholecystectomy is a common abdominal surgery, and many are laparoscopic in developed countries. For example, 90% of cholecystectomies in the US are laparoscopic [1]. Laparoscopic cholecystectomy is the \"gold standard\" for gallstone surgery. This technique reduces pain, improves cosmesis, shortens hospital stays, and reduces work impairment [2\u0026ndash;8]. Laparoscopic cholecystectomy has a greater complication risk than open surgery. The indications Include symptomatic cholelithiasis, Asymptomatic cholelithiasis in patients at risk for gallstones or gallbladder cancer. acalculous Cholecystitis, Polyps\u0026thinsp;\u0026gt;\u0026thinsp;0.5cm, porcelain gallbladder. Contraindications include diffuse peritonitis with hemodynamic compromise and uncontrolled hemorrhage [11]. Intraoperative complications like Vascular injury, intestine perforation, mesenteric injury, and bile duct injuries require prompt laparotomy. Laparoscopic surgery should be switched to open if the surgeon needs manual palpation and direct visualization. If necessary, surgeons should perform open surgeries. The gallbladder hole can be closed with forceps or sutured to avoid additional spilling. Suction and irrigate the bile. Bile spilling without stone spillage does not aggravate postoperative infections [11]. Gallstones, especially pigment stones, which harbor germs, can increase postoperative infection risk [12\u0026ndash;17]. If possible, extract any discharged gallstones.\u003c/p\u003e \u003cp\u003eThis task requires large stone graspers. If a trocar impales a major blood vessel, it should be left in place and a laparotomy performed immediately. Trocars should be seen with the laparoscope when removed to check for lacerated abdominal wall vessels. Bleeding can be managed via cautery, Foley catheter balloon tamponade, or a figure-of-eight stitch. Observe and mark bowel damage throughout and after the case. If there is leakage, it can be fixed laparoscopically or openly by extending the umbilical incision. Laparoscopic surgery can then start. Bile duct damage should be corrected immediately. Indocyanine green fluorescence imaging could describe biliary anatomy and avoid bile duct damage. The technique isn't proven, but it seems promising [16,17]. Some bile duct injuries aren't identified during surgery and manifest later. All should be referred to an experienced biliary surgeon because the initial procedure has the best probability of success. If the surgeon is elsewhere, the patient should be externally drained.\u003c/p\u003e \u003cp\u003eThe goal of this study is to share our experience with LC problems, which have a morbidity rate of about 1.4 percent when performed in teaching hospital, yet major LC complications can be handled by skilled surgeons.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cp\u003eThis retrospective study included 564 patients who had laparoscopic cholecystectomies at Mogadishu Somali Turkey Training and Research Hospital from January 2018 to January 2022. The following data was retrospectively reviewed: patient demographics (age, gender), preoperative investigations (CBC, bleeding-coagulation times, liver function tests, renal function tests, blood glucose level, screening for hepatitis), intra-operative findings (duration of operation, intra-operative bleeding and iatrogenic injuries), conversion from laparoscopic to open cholecystectomy and reason for conversion, postoperative complications (hemorrhagic complications). The study excluded patients with incomplete files. Four-port laparoscopic cholecystectomies were performed. Three months of care follows surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLocal ethical committee accepted study protocol (Mogadishu Somali Turkey Training and Research Hospital).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn the course of our research, a total of 564 patients were evaluated, with 465 females (82 percent) and 99 men (18 percent) . The number of females to males was 9 to 2. The gender distribution is presented in \u003cstrong\u003eTable 2\u003c/strong\u003e. The majority of the patients were in the age range of 20 to 29 years old (22.5 percent), followed by the age range of 40 to 49 years old (20 percent ). 45 years was the average age of all of the patients.\u003c/p\u003e\n\u003cp\u003e(\u003cstrong\u003eTable 1)\u003c/strong\u003e. In the course of our study, the average amount of time spent in operation was 48 minutes, with a range of 15\u0026ndash;90 minutes. The operational time is showed in \u003cstrong\u003eTable 5\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e25 out of 564 individuals required an open cholecystectomy as a result of the initial operation (4.4 percent ). \u003cstrong\u003eTable 7\u0026nbsp;\u003c/strong\u003eshows laparoscopic cholecystectomies which were Converted to open cholecystectomy.\u003c/p\u003e\n\u003cp\u003eThe rationale behind the conversion is detailed in \u003cstrong\u003eTable 3\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eIn the course of our research, we discovered that there were a total of two duodenal injuries and six significant bile duct injuries. The two injuries to the duodenum were treated with primary repair, while the injuries to the bile duct were transferred to a hepatobiliary center for further evaluation. During the operation, 121 patients experienced gallbladder perforation; however, none of these patients went on to develop intraabdominal sepsis. The difficulties are outlined in \u003cstrong\u003eTable 4\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e103 patients, or 18.3 percent, had their operations in the morning and were discharged the following morning. The average length of time spent in the hospital following surgery was 70 hours (range: 24-120). The length of time hospital stays is detailed in \u003cstrong\u003eTable 6.\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLaparoscopic cholecystectomy (LC) is the surgery of choice in modern medicine for treating gallstone disease with symptoms. The LC treatment was initially recommended for patients with simple cholelithiasis at our facility. LC, on the other hand, was made available for patients with acute calcular cholecystitis when the additional experience was gained. The age and gender distributions seen in our study were similar to those observed in previous findings (18). The average operating duration in our study was 48 minutes, which is less than the 70-90 minute range reported in other studies (18-20).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis was most likely due to our case selection policy. Eighteen percent of our patients were discharged home without difficulties or readmissions on the first postoperative day. The conversion rate was 4.4 percent. This is in line with the results of other studies (22-27). \u0026nbsp;The most common causes of conversion in our study were dense adhesion and fibrotic gallbladder. Bleeding is one of the most well-known cholecystectomy side effects. Clinically severe bleeding was noted in 0.5 percent of LC patients (17). Three patients in our series experienced bleeding, necessitating an open cholecystectomy. Because of dense adhesion (13), fibrotic gallbladder (6), bleeding (3), and acute inflamatory adhesion in three of the patients, 25 patients had their surgeries converted to open cholecystectomies (0.5 percent ). Laparoscopic cholecystectomy (LC) is technically more difficult when dealing with acute cholecystitis than when dealing with elective cases.\u003c/p\u003e\n\u003cp\u003eDue to significant inflammation and increased adhesion, the anatomy around the calot\u0026apos;s triangle is obscured, making dissection difficult and potentially dangerous. Conversion should not be viewed as a complication in these instances; rather, it should be viewed as an endeavor to resolve concerns through greater surgical procedures (28).\u003c/p\u003e\n\u003cp\u003eLaparoscopic cholecystectomy (LC) has a number of advantages over open cholecystectomy, but it comes with its own set of risks (29). The risk of biliary tract damage with the laparoscopic technique ranges from 0.2 percent to 0.9 percent. This is a particular source of concern (31-35). The relatively high rate of bile duct injury that can occur during laparoscopic cholecystectomy (LC) is considered by many surgeons to be the procedure\u0026apos;s principal problem. Injury to the bile duct is associated with a high rate of morbidity, as well as prolonged hospitalization, a higher financial burden, the risk of legal action, and, in some cases, even death (24). On the other side, as more surgeons gain experience, the incidence of this complication is likely to decrease (30).\u003c/p\u003e\n\u003cp\u003eFor five days, two patients had bile flowing through the drain in a continuous . \u0026nbsp;The laparotomy that was conducted to repair the duodenal injury was successful. Gallbladder perforation during surgery occurred in 121 cases, accounting for 21.4 percent of the total. This is in contrast to the incidence, which has been estimated to be between 10% and 32%. (25). The dissection of the gallbladder bed, the retraction of the gallbladder, the removal of the gallbladder from the liver, and the sliding of cystic duct clips are the most prevalent causes of bile spilling.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe fact that the rates of complications and overall conversion rate fall within acceptable limits demonstrates that laparoscopic coblation (LC) is a safe minimally invasive method. Our results were in line with the findings of the previous studies. However, When there is a complication, a multidisciplinary approach is required.\u003c/p\u003e\n\u003cp\u003eThe procedure should be carried out in a high-volume hospital. because it would be beneficial in terms of mortality morbidity.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLaparoscopic Cholecystectomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eComplete Blood Count\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was reviewed and approved by the Ethical Committee \u003cem\u003eof\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eMogadishu Somali Turkish Training and Research Hospital (Date:21.02.2022 , Decision No. 493, Ref. MSTH/9200), due to retrospective design, informed consent was not obtained by the ethics committee rule.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe data is available from the corresponding author and can be accessed if requested.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declare that we have any no competing of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declare that we have no funding source.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA. A.M: brought the idea of the study, performed data collection, prepared the manuscript, and final revision.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eJ. A.O: participated in the data Analysis. All authors read and approved the manuscript before submitting.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003e\u003ca href=\"https://www.uptodate.com/contents/laparoscopic-cholecystectomy/abstract/1\"\u003eCsikesz NG, Singla A, Murphy MM, et al. Surgeon volume metrics in laparoscopic cholecystectomy. Dig Dis Sci 2010; 55:2398.\u003c/a\u003e\u003c/li\u003e\n \u003cli\u003e\u003ca href=\"https://www.uptodate.com/contents/laparoscopic-cholecystectomy/abstract/2\"\u003eSoper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new \u0026apos;gold standard\u0026apos;? 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Laparoscopic cholecystectomy: the other side of the coin. BMJ. 1996 Jun 1;312(7043):1375-6.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"tables","content":"\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eTable 1:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eAge distribution of the patients\u003c/span\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eAge group (in years\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eFrequency\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid black;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003ePercentage %\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e20-29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e127\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e22.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e30-39\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e105\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e18.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e40-49\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e113\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e20.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e50-59\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e89\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e15.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e60-69\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e77\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e13.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e70-79\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e41\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e7.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e\u0026gt;=80\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e12\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e2.1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eTotal\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e564\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e100.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eTable 2:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eGender distribution of the patients\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: none;border-bottom: none;border-left: none;border-image: initial;border-top: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eGender\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-right: none;border-bottom: none;border-left: none;border-image: initial;border-top: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eFrequency\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-right: none;border-bottom: none;border-left: none;border-image: initial;border-top: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003ePercentage\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eMale\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e99\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e18\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border: none;padding: 0in 5.4pt;height: 17.85pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eFemale\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border: none;padding: 0in 5.4pt;height: 17.85pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e465\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border: none;padding: 0in 5.4pt;height: 17.85pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e82\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e564\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e100.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eTable 3:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eReasons For Conversion\u003c/span\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width:450.45pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 241.95pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eReasons For Conversion\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 208.5pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eFrequency (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 241.95pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eDense Adhesion\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 208.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e13(2.3%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 241.95pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eFibrotic Gallbladder\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 208.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e6(1%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 241.95pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eIntraoperative Bleeding\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 208.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e3(0.5%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 241.95pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eAcute Inflammatory adhesion\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 208.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e3(0.5%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 241.95pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 208.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e25(4.4%\u003c/span\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family: \"Times New Roman\",serif;'\u003e)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eTable 4:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003epost-operative complications of LC\u003c/span\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213.05pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003ecomplications of LC\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213.05pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eFrequency (%)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213.05pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eBile duct injury\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e6(1.0%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213.05pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eDuodenal Injury\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e2(0.40%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213.05pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eGallbladder perforation\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e121(21.4%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213.05pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eIntra operative bleeding\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e65(11.6%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213.05pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 213.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e194(34.4%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eTable 5:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eOperative time\u0026nbsp;of LC\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eOperative time\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eFrequency\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003ePercentage\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e15-30 min\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e285\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e50.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e30-60 min\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e250\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e44.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e\u0026gt; 60 min\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e5.1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eTable 6:\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003cspan style='font-size: 16px; line-height: 115%; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003eHospital stay\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eHospital stay\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003eFrequency\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:115%;font-family:\"Times New Roman\",serif;'\u003ePercentage\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e24Hour\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e103\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e18.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e2 day\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e399\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e70.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e\u0026gt;2days\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e62\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; 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font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e564\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142.05pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size: 16px; font-family: \"Times New Roman\", serif; color: rgb(0, 0, 0);'\u003e100.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cholecystectomy, Laparoscopic Cholecystectomy, Complications Associated with Cholecystectomy","lastPublishedDoi":"10.21203/rs.3.rs-1680188/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1680188/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe most common surgical procedure for the digestive tract is laparoscopic cholecystectomy. It has replaced open cholecystectomy as the gold standard treatment for gallbladder inflammation and cholelithiasis. In Somalia, it is estimated that over 90% of cholecystectomies are performed laparoscopically. The goal of this study was to assess the result of laparoscopic cholecystectomy in terms of complications, conversion rate, and length of stay at a tertiary care hospital.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis retrospective analysis was conducted on 564 patients who had laparoscopic cholecystectomies at Mogadishu Somali Turkey Training and Research Hospital between January 2018 and January 2022, and the essential data is collected and analyzed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 564 patients were studied in this study, with 99 men (18%) and 465 females (82 percent ). The patients ranged in age from 20 to 90, with a mean age of 45. In our study, the operative time ranged from 15 to 90 minutes. The conversion rate was 4.4%. Six patients had bile duct injuries (1.0 percent ).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eGallstone disease is increasingly international. Laparoscopic cholecystectomy has replaced open cholecystectomy as the preferred gallstone treatment. Most gallstone patients are female. Male gender, thick adhesions in Calot's triangle, advanced age, Acute cholecystitis, dense adhesions, and fibrosis, and less surgeon experience increase the likelihood of an open cholecystectomy.\u003c/p\u003e","manuscriptTitle":"Laparoscopic Cholecystectomy in a tertiary care teaching hospital-retrospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-06-22 19:52:48","doi":"10.21203/rs.3.rs-1680188/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"928c444c-c4d9-47a0-92cc-1db72a2f3ba2","owner":[],"postedDate":"June 22nd, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-06-22T19:52:48+00:00","versionOfRecord":[],"versionCreatedAt":"2022-06-22 19:52:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1680188","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1680188","identity":"rs-1680188","version":["v1"]},"buildId":"pf3fE39SIOqb-0xH_OWvX","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}