International Journal of Health Research and Medico Legal Practice

N. Ganguly Narendra ¹, Bhattacharjee Nilutpal ², Choudhury Purujit ³, Rathi Rohit ⁴, Deka Nilotpal ⁵

Affiliations
1 Jorhat Medical College and Hospital, Assam, IN
2 Jorhat Medical College and Hospital, Jorhat, Assam, IN
3 Gauhati Medical College and Hospital, Guwahati, Assam, IN
4 SGE, J B Pant, New Delhi, IN
5 General and Minimally invasive Surgery Swagat Hospital, Guwahati, Assam, IN

Abstract

A randomized controlled trial has been conducted to evaluate the role of octreotide in reducing serum amylase and lipase in patients admitted with acute pancreatitis. 100 patients with acute pancreatitis were selected for the study and the effect of sub-cutaneous octreotide was looked into in reducing the serum levels of the enzymes, amylase and lipase. Out of these 100 cases, 56 patients had acute biliary pancreatitis, 33 patients had acute alcoholic pancreatitis and 8 patients had idiopathic pancreatitis. There were 2 patients with biliary helminthiasis presenting with acute pancreatitis and 1 patient presented with acute pancreatitis following trauma. Serum amylase and lipase was recorded in all patients on admission. Octreotide (100 micrograms x 3) was given subcutaneously to 50 patients selected randomly along with conventional treatment (Group A) and other 50 patients were given only conventional treatment (Group B) irrespective of their aetiology, age, sex and severity. Serum amylase and lipase was again measured after 48 hours of admission. The change in the level of serum amylase and lipase was calculated in both Group A and Group B and statistical significance was determined. In our study those patients who received octreotide, i.e., Group A had a reduction of serum amylase by 82% and serum lipase by 70% whereas those patients who did not receive octreotide, i.e., Group B had a reduction of serum amylase by 73% and serum lipase by 59%. This difference between Group A and Group B was found to be statistically significant for both serum amylase (p=0.0028) and serum lipase (p=0.0437) by T-test and (p=0.00798 and p= 0.0437) by Mann-Whitney U test respectively.

Keywords

Octreotide, Amylase, Lipase, Pancreatitis, Mann-Whitney Test.

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N. Ganguly Narendra ¹, Gautam Kumar ²

Affiliations
1 Gauhati Medical College and Hospital, IN
2 Dept. of Surgery, Gauhati Medical College and Hospital, IN

Abstract

Improvements in the field of diagnostic studies as well as better understanding of various benign conditions affecting gallbladder may explain the rise in the incidence of it, including gallstones rather than the change in the living standards of Indian population. In the present scenario, this study tries to find out the instance of other benign conditions of gallbladder amongst the patients presenting themselves for laparoscopic cholecystectomy. This study will also look through a detailed review of literature whether in these benign conditions of gallbladder, laparoscopic procedure should be the procedure of choice.

All the patients admitted with symptomatic gallbladder diseases are treated with cholecystectomy. After the advent of laparoscopic surgery, laparoscopic cholecystectomy has become the gold standard procedure for gallbladder removal for benign indications and is the preferred mode of surgery now. Many comparative studies between laparoscopic cholecystectomy and open cholecystectomy in developed countries have been discontinued because patients are refusing the open procedure for the superior procedure, i.e., laparoscopic cholecystectomy primarily due to its completeness and safety, better cosmesis and almost no post-operative pain and discomfort.

This study tried to find out the spectrum of the benign diseases/conditions of gallbladder, which necessitate its removal and also keep in mind about the documented premalignant conditions of the gallbladder, which are benign; and evaluate the prognosis of the patients with such conditions over a period of time to understand whether laparoscopic cholecystectomy should be considered to be the proper form of therapy in all these patients.

Keywords

Benign, Gallbladder, Cholecystectomy, Laparoscopic.

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