[Show abstract][Hide abstract] ABSTRACT: Background and Objective: Acute gallstone pancreatitis is quite common throughout the globe. Conventionally definitive cholecystectomy has been delayed in index hospital admission. Since the last decade timing of cholecystectomy is gradually shifting towards the earlier phase of disease and currently gallstone pancreatitis is being evaluated as a further indication for laparoscopic cholecystectomy. There is also great concern regarding compliance of patients for definitive surgery due to poverty, ignorance and illiteracy in developing countries. The aim of this study was to assess the feasibility and safety of laparoscopic cholecystectomy as a definitive treatment in patients with mild and resolving gall stone pancreatitis.
Methods: This was a prospective study from July 2009 to June 2012. Patients were diagnosed by clinical examination, biochemical tests, ultrasonography and contrast enhanced CT. Patients with mild form of the disease (Ranson Score ≤3) and who showed clinical improvement were offered laparoscopic cholecystectomy in index hospital admission. Those who were unfit for surgery were referred for endoscopic sphincterotomy. Common bile duct stones were excluded preoperatively.
Results: A total of 38 patients were admitted with acute gallstone pancreatitis in the study period. The mean age of patients was 46.3 years with male to female ratio of 11/27. 22 (57.8%) patients were selected for laparoscopic cholecystectomy and procedure was completed successfully. Ten (26.3%) patients were referred for ERCP and endoscopic sphincterotomy and 11 (28.9%) were managed by conservative treatment and went without any definitive treatment. Mean duration of time from onset of symptoms and laparoscopic cholecystectomy was 7 days (range 4-10). Mean duration of operative time was 45 minutes and hospital stay was 7 days. There was no operative mortality. No major intra-operative or post-operative complication was recorded. two patients (9%) had minor complications.
Conclusion: Laparoscopic cholecystectomy can be safely performed in selected cases of mild gallstone pancreatitis in order to prevent further attacks of acute pancreatitis and other consequences of delayed treatment. Furthermore it resolves the problem of noncompliance of patients in third world countries where many patients are lost for definitive treatment.
Pakistan Journal of Medical Sciences Online 05/2014; 30(3):601-5. DOI:10.12669/pjms.303.4380 · 0.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: To study the incidence, pattern of injuries, presentation and management of stray bullet injuries.
Methods: All patients presented and admitted with stray bullet injuries during a period of 4 years from January 2006 to December 2010 were included in this prospective study which was conducted at Liaquat University of Medical and Health Sciences Hospital Hyderabad/Jamshoro. All of the study subjects were admitted through casualty and were initially thoroughly examined and resuscitated. The pattern of injuries was noted and requisite investigations performed. Patients who sustained injuries demanding surgery were prepared accordingly and were submitted for laparotomy or other procedures depending upon the severity of injuries. The data collected on individual basis and variables studied including demographics, pattern of injuries, time since injury occurred and management.
Results: A total number of 165 patients with a mean age of 17.1 years, SD 13.807 and range of 74(2-76) presented with stray bullet injuries during study period. The study population comprised 117(70.90%) males and 48(29.09%) females. Majority of the patients were brought late because of delay in diagnosis or delay in transportation. The commonest victims were young children in their teens and comprised 78% of the study population. Haemothorax/ pneumothorax or peritonitis was the common presentations occurring in 11% and 61.81% of the study population respectively. Of the total number, 92 (55.75%) patients underwent laparotomy while remaining patients either had chest intubation or some other procedures done accordingly. Nine (5.45%) patients developed permanent disabilities while 13(7.87%) patients died either immediately after arrival or later on in the hospital during or after the operative treatment. Mortality was related to the time of arrival in hospital since the injury and thus was highest among those brought 4 or more hours after the shot (P<0.001). Patients who did not sustain major injuries were kept under observation and were subsequently discharged.
Conclusion: Stray bullet injuries are an ever increasing challenge in our society. Unlawful and jubilant use of weapons in celebrations, weddings and similar occasions are causing a lot of morbidity and mortality in the society.
Pakistan Journal of Medical Sciences Online 09/2013; 29(5):1178-81. DOI:10.12669/pjms.295.3794 · 0.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives: This study reports the indications and outcome of various biliary bypass surgical procedures from a single centre over a period of 10 years.
Methods: This is a prospective observational study conducted over a period of 10 years (January 2001-december 2010). A total of 1500 patients were included, who underwent pancreatico-biliary surgery due to common bile duct (CBD) stones, congenital anomalies of biliary tree, unoperable pancreatico-biliary malignancies, CBD strictures and cases who developed iatrogenic biliary injuries during cholecystectomy (both open & laproscopic) during this period of time. The patients who required biliary bypass surgery were further analysed for indications and outcome.
Results: Out of 1500 patients 83(5.53%) required biliary bypass surgical procedures. The CBD stones were observed as the most common indication (25.3%), followed by CBD injuries after open(10.84%) or laproscopic-cholecystectomy (14.46%), carcinoma head of pancreas (12.05%) and CBD obstruction(14.46%) either due to CBD strictures or unknown distal obstruction. Roux-en-Y-hepatico-jejunostomy (26.51%) was the most frequently performed procedure, followed by choledochoduodenostomy and Roux-en-Y choledocho-jejunostomy (i.e. 25.3% and 12.05% respectively). Roux-en-Y biliary bypass procedure was observed to be associated with better outcome in terms of rate of complications as well duration of hospital stay.
Conclusion: Biliary bypass surgical procedures are the better options to restore the continuity of biliary system in patients with iatrogenic biliary tree injuries and un-operable pancreatico-biliary malignancy. Roux-en-Y biliary bypass procedure is safe and problem solving method in these cases.
Pakistan Journal of Medical Sciences Online 05/2013; 29(3):799-802. DOI:10.12669/pjms.293.3394 · 0.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abdominal tuberculosis is extremely common in developing countries such as Pakistan and India. The presentation is varied and nonspecific, making the diagnosis extremely difficult at times. This study was performed to find out the efficacy of diagnostic laparoscopy in establishing the histopathological diagnosis of abdominal tuberculosis.
An analytical descriptive study of 109 patients with abdominal tuberculosis diagnosed by laparoscopy was conducted over a period of 5 years (between January 2004 and December 2009) in a teaching hospital and in various private hospitals. All patients with vague abdominal symptoms and suspicion of abdominal tuberculosis were admitted and examined thoroughly. Data were collected and statistically analyzed using SPSS version 16.
A total of 133 patients with vague abdominal symptoms and an unsettled diagnosis were included in this series, of which 109 (82%) patients were diagnosed with abdominal tuberculosis on laparoscopy. The common symptoms were pain in abdomen, changing bowel habits, loss of weight, and generalized weakness. Clinical examination was not significant, except for anemia in the majority and generalized abdominal tenderness in a few patients. Various tuberculous lesions were detected on laparoscopy. Biopsy of the specimens proved abdominal tuberculosis in 109 patients. Patients were saved from unnecessary laparotomies and were managed on antituberculosis drug therapy.
Diagnostic laparoscopy is an efficient and reliable diagnostic tool for patients suspected with abdominal tuberculosis.
[Show abstract][Hide abstract] ABSTRACT: To investigate the pattern of presentation, severity, factors responsible for delayed presentation and outcome of breast cancer in patients presenting to a teaching hospital of Jamshoro.
It's a prospective descriptive study of 103 malignant breast lumps treated at a tertiary care teaching hospital over a period of 8 years. All patients were admitted through Outpatients department and were thoroughly examined and investigated. Treatment offered was based on triple assessment and ranged from lumpectomy to toilet mastectomy depending upon the stage of disease. The variables studied were recorded on a proforma and analyzed on SPSS version 12 for measuring frequencies and using Chi square test where applicable.
The mean age of the study population was 39.17 +/- 6.019 years and a range of 22 to 54 years. The frequency of advanced malignancy was alarmingly high in younger patients. Intra- ductal carcinoma was the commonest tumour in 93 (90%) patients, while the remaining included lobular (07) and Paget's disease (03). The high figures of advanced disease at presentation is attributed to lack of knowledge and education, poverty and local customs of women not exposing themselves even to the physicians. In addition, there is a substantial delay in the referral of patients from under privileged, remote areas where patients continue to receive symptomatic treatment till such time that disease becomes incurable.
Advanced breast disease is common in younger patients belonging to underprivileged and remote rural areas. Great efforts are required to educate people so as to make early diagnosis possible
Journal of the Pakistan Medical Association 09/2010; 60(9):718-21. DOI:10.1016/S0378-5122(09)70174-4 · 0.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To compare the postsurgical outcome of laparoscopic and open inguinal varicocelectomy.
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, from July 2003 to June 2007.
One hundred seven patients underwent either open inguinal or laparoscopic varicocelectomy. Diagnosis was made by clinical examination and color Doppler scan in doubtful cases. Pre-operative semen analysis was done in all patients. Operative time, postoperative analgesic requirement in number of tablets, hospital stay in days, improvement in semen parameters in subfertile subjects, pain on visual analog score. and postoperative complications were recorded and compared between the two groups.
There were 50 patients in each group, with age ranging from 12-50 years (26.9+/-7.67 in open inguinal and 26.2+/-7.08 in laparoscopic group). Average operative time was 34.8+/-7.89 minutes for open inguinal and 43.8+/-8.95 minutes for laparoscopic group. The analgesic requirement was 16.3+/-1.58 tablets in the open inguinal and 11.3+/-2.23 in the laparoscopic group. Postoperative pain was significantly less in the laparoscopic group. There was statistically significant (p < 0.001) improvement in sperm count as well as motility in both groups irrespective of procedure.
The open inguinal (Ivanissevich) procedure and laparoscopic varicocelectomy had almost equivalent postoperative outcomes regarding improvement in semen parameters and postoperative complications. Open inguinal procedure had a shorter operating time while laparoscopic varicocelectomy had the advantage of less analgesic requirement and short hospital stay. On the whole, open inguinal (loupe magnified) varicocelectomy is an effective procedure where availability and costs of laparoscopic instruments are barriers.
Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 02/2010; 20(2):106-11. · 0.35 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess the frequency of anatomical variations of extrahepatic biliary system in patients undergoing laparoscopic cholecystectomy.
This is an observational study performed in the Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro for a period of four years from January 2004 to December 2007. All diagnosed patients of cholelithiasis undergoing routine laparoscopic cholecystectomy were assessed for anatomical/congenital extra hepatic biliary and vascular anomalies. Structures mainly assessed for anomalies were gall bladder, cystic duct, supraduodenal part of Common Bile Duct (CBD), cystic artery and hepatic artery which are routinely handled during laparoscopy. However, assessment of variations and anomalies, of hepatic ducts, portal vein, retroduodenal and pancreatic parts of CBD were not done due to possibility of iatrogenic injuries.
Three hundred cases of cholelithiasis comprising 255 (85%) females and 45 (15%) males with mean age of 39.85 +/- 18.82 years were included in the study. Patients mainly presented with upper abdominal pain including pain in right hypochondrium (71.67%), pain in right hypochondrium and epigastrium (19%) and pain in epigastrium alone (9.33%) as main symptoms. Operative findings revealed variations in 61 (20.33%) patients mainly involving cystic artery (10.67%), cystic duct (4.33%), right hepatic artery (2.67%) and gallbladder (2%). Postoperatively 3.67% revealed bleeding and 1.67% biliary leak from drain as main complications related to anatomical variations giving rise to 1% morbidity, however, no mortality was seen in this series.
Congenital anomalies and normal variants of biliary tree, are not common but may be of significance during laparoscopic surgery as failure to recognize them leads to iatrogenic injuries and can increase morbidity and mortality.
Journal of the Pakistan Medical Association 02/2010; 60(2):89-93. · 0.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To study various factors influencing outcome of open hernia repair in elderly population.
This is a retrospective descriptive study from January 2004 to December 2008 including all patients (n = 212) of 60 years and above operated for inguinal hernias either electively or in emergency during this period. One of the co-authors was assigned the duty to collect the record files of all patients over 60 years age operated for inguinal hernia in the department of surgery LUMHS as well as in private hospitals in Hyderabad. The records of all patients were reviewed and data retrieved on a proforma mentioning variables to investigate the common co-morbidities and their influence on the overall results of surgical intervention in geriatric patients. SPSS version 12 was used for statistical analysis of the data.
The mean age of the patients in this series was 69.82 +/- 7.8 years of whom 208 (98%) were males and 4 (2%) females. In 190 (89.61%) patients the hernias were unilateral while 12 (5.7%) cases had bilateral inguinal hernias and 10 (4.7%) patients presented with recurrent hernias. In 159 (75%) patients the hernia was simple while 53 (25%) patients presented with one or the other complication such as obstruction or strangulation. Elective surgery was performed in 161 (75.9%) patients while 51 (24.1%) patients were operated in emergency. Co-morbidities were present in 79 (37.26%) patients. Out of the total study population, 7 (3.30%) patients died of which 6 were operated in emergency and had co-morbidities. All of them had gangrene of bowel for which resection and anastomosis was done. One patient died of acute MI on 5th post-operative day.
Emergency hernia surgery carries a high mortality in elderly patients. Co-existing medical problems make surgery still challenging in the geriatric population. An early elective hernia repair is highly recommended.
Journal of the Pakistan Medical Association 01/2010; 60(1):45-7. · 0.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective:
To deteremine the incidence, nature and management of extra-biliary complications of laparoscopic cholecystectomy.
Materials and Methods:
This study presents a retrospective analysis of extra-biliary complications occuring during 1046 laparoscopic cholecystectomies performed from August 2003 to December 2006. The study population included all the patients with symptomatic gallstone disease in whom laparoscopic cholecystectomy was performed. The extra-biliary complications were divided into two distinct categories: (i) Procedure related and (ii) Access related.
The incidence of access-related complications was 3.77% and that of procedure-related complications was 6.02%. Port-site bleeding was troublesome at times and demanded a re-do laparoscopy or conversion. Small bowel laceration occurred in two patients where access was achieved by closed technique. Five cases of duodenal and two of colonic perforations were the major complications encountered during dissection in the area of Calot's triangle. In 21 (2%) patients the procedure was converted to open surgery due to different complications. Biliary complications occurred in 2.6% patients in the current series.
Major extra-biliary complications are as frequent as the biliary complications and can be life-threatening. An early diagnosis is critical to their management.
Journal of Minimal Access Surgery 02/2008; 4(1):5-8. DOI:10.4103/0972-9941.40990 · 0.81 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An overall increase in the incidence of paediatric cholelithiasis forms the basis of this study, which aims to investigate the overall changing clinical pattern of cholelithiasis. Methods: This is a retrospective observational descriptive study including twenty three (23) patients with gallstones admitted and operated during June 2006-June 2008 in surgical department of a teaching hospital. All the patients with sonological evidence of gallstones, less than 10 years of age with history of acute or chronic abdominal symptoms are included in the study population. After admission all the subjects were investigated and finally operated by open approach (21 patients) during the same admission. The details of all the patients were recorded on a proforma and statistical analysis done on SPSS version 12.
Of the total study population, there were 19 (82.6%) males and 4 (17.39%) females with a mean age of 7 years and a range of 4-10 years. Ultrasound revealed gallstones in all the patients with a varying proportion of the walls of gallbladder. The commonest presentation was abdominal pain in the right upper quadrant, which was vague, and of mild to moderate intensity. In 21 (91.30%) patients, no specific underlying cause was found while two patients (8.6%) had haematological disorder as underlying cause for the gallstones.
This study indicates an alarming increase in the incidence of idiopathic gallstones in children less than 10 years of age with a distinct male predominance.
Journal of Ayub Medical College, Abbottabad: JAMC 01/2008; 20(4):34-6.
[Show abstract][Hide abstract] ABSTRACT: To find out the safety profile of laparoscopic cholecystectomy in empyema of gallbladder.
Empyema of gall bladder is a severe form of acute cholecystitis with superadded suppuration. It has been considered a contraindication for the laparoscopic cholecystectomy (LC) because of fear of life-threatening complications. This study aimed to determine the safety and feasibility of LC in empyema of gallbladder.
LC was attempted in 67 patients of empyema of gallbladder within 24h. However in few cases there was a delay because of reluctance for surgery or delay in giving consent etc. The procedure was performed by standard four-port technique with few changes made to facilitate dissection according to situation.
Between April 2003 to June 2006, 970 LC performed for gallstone disease at surgical unit-1 of LUMHS by the same surgical team. Among these, 67 (6.90%) patients were diagnosed to have empyema gall bladder. LC successfully completed in 54 (80.59%) patients. In 13 (19.40%) patients the procedure was converted to open cholecystectomy (OC) due to various operative difficulties of which the most serious injuries included bleeding from cystic artery (four cases), common bile duct injury (two cases) and duodenal injury in one case. Maximum operating time was up to 160 minutes (one case). Postoperative complications occurred in 10 (18.51%) successfully operated patients. Maximum patients (n=45, 83.33%) were discharged in 48-96 hours while three patients were discharged after two weeks.
Laparoscopic cholecystectomy can be performed in empyema of gallbladder keeping in mind a slightly increased risk of complications even in the best hands. However, the experience of the surgeon plays a key role in the overall outcome.
Journal of Minimal Access Surgery 04/2007; 3(2):52-6. DOI:10.4103/0972-9941.33273 · 0.81 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Advancing age with its associated co-morbidities increases the likelihood of postoperative complications as well as conversion rate during laparoscopic cholecystectomy. Recent studies have also questioned efficacy of this procedure in geriatric patients. The present study assesses the safety and applicability of laparoscopic cholecystectomy in geriatric patients. The objective of the present study was to asses safety and applicability of laparoscopic cholecystectomy in the elderly patients of 65 years and above.
This is a prospective analysis of 173 patients, over 65 years of age, who underwent laparoscopic cholecystectomy from December 2002 to November 2006 at Liaquat University Hospital, Jamshoro. Patients presenting with complicated and uncomplicated gallstone disease were included in the study population and all of them were operated laparoscopically. The data included demographic details, co-morbidities, underlying biliary pathology, indications for surgery, operative and postoperative complications, morbidity and mortality, and hospital stay. The statistical analysis of the data performed on SPSS version 10.
Laparoscopic cholecystectomy undertaken in 173 elderly patients with a mean age of 69.72 years, out of whom 52 (30.05%) were males and 121 (69.94%) were females. Co-morbid conditions were identified in 53.17% (n = 92) patients and included hypertension in 38 patients (21.96%), Diabetes Mellitus in 23 patients (13.29%), COPD in 19 (10.98%) patients, Coronary artery disease in 9 (5.20%) and cardiac arrhythmias in 3 (1.73%) patients. Indications for surgery included simple biliary colic in majority of patients (69.94%) and complicated stone disease in 52 (30.05%) subjects. There were 37 (21.38%) emergency laparoscopic cholecystectomies and 136 (78.61%) patients were operated electively. Mean operative time was 100 minutes with a SD 29.03. Fourteen (8.09%) patients required conversion to OC (Open Cholecystectomy) due to various reasons. Mean hospital stay was 6.28 days. Overall 23 (13.29%) patients developed postoperative complications. One patient died of acute MI on 2nd postoperative day.
There is no undue risk in laparoscopic cholecystectomy in the elderly population and the procedure can be regarded as safe as in patients below 65 years of age.
Journal of Ayub Medical College, Abbottabad: JAMC 01/2007; 19(4):45-8.
[Show abstract][Hide abstract] ABSTRACT: Synchronous bilateral testicular tumors are a rare entity. One such case of an elderly male is reported who presented with bilateral painless testicular swellings of 3 months duration. After clinical workup, provisional diagnosis of bilateral testicular tumors was made and bilateral orchidectomy was performed. Histopathology report revealed bilateral seminoma.
Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 09/2006; 16(8):538-9. · 0.35 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The groin hernia repair is one of the common operations in general surgery. The optimum repair method is under debate and the best mode of repair is yet to be decided. This study is conducted to compare the results of open non-mesh (Modified Bassini's) and Lichtenstein's mesh repair of primary inguinal hernia in terms of recurrence, postoperative complications and quality of life in the long-term.
This retrospective comparative analytical study includes 840 patients of which 40 patients were excluded from the study due to various reasons. The remaining 800 patients with unilateral primary inguinal hernia, above 16 years of age, operated during January 2000 to December 2007 in a teaching hospital are included in the study. Of the total number, 392 patients (49%) underwent Lichtenstein mesh repair, while remaining 408 patients (51%) were operated by modified Bassini's suture technique. Follow up was conducted 1, 5, 8 and 15 days; 1, 2, 6, 24 and 36 months.
The recurrence rate and postoperative pain were significantly low in Lichtenstein mesh repair compared to open non-mesh repair by modified Bassini's technique (p < 0.001). Recurrence occurred in 8 (2.0%) out of 392 patients those with Lichtenstein mesh repair. On the other hand 29 (7.1%) patients with Bassini's repair reported recurrence within 3 years time.
Mesh repair of inguinal hernia is much superior to non-mesh repair in terms of recurrence and postoperative chronic pain.
Journal of Ayub Medical College, Abbottabad: JAMC 21(1):17-20.
[Show abstract][Hide abstract] ABSTRACT: Appendicular mass is a well-known complication of acute appendicitis. It is conventionally treated conservatively followed by interval appendectomy. This study aimed to determine the feasibility and safety of an early appendectomy in these cases.
Descriptive and comparative.
Department of Surgery Liaquat University Hospital, Jamshoro/Hyderabad from March 2003 to December 2007.
One hundred and seventy six (176) patients with appendicular mass were included in this study. Patients were conveniently divided into two groups, A and B with equal distribution of cases (88 Patients each), regardless of age and sex. Immediate appendicectomy was performed in group A patients after preliminary investigations, where as patients in group B were initially treated conservatively followed by interval appendicectomy.
A total 114 (64.8%) males and 62 (35.2%) females with a mean age of 25.09 years (Range 8-44 years) are included in the study population. Post-operative wound sepsis occurred in 17 (19.31%) patients in group A. Treatment failure, patient compliance, re-admission and overall expenses are main limitations in group B population.
Early appendicectomy is a safe and superior option in patients with appendicular mass compared to conventional treatment.
Journal of Ayub Medical College, Abbottabad: JAMC 20(1):70-2.
[Show abstract][Hide abstract] ABSTRACT: Breast cancer is most common in females affecting nearly one out of nine women sometimes in their life. The main objective of this hospital based study was to find out the pattern of benign breast lumps in young Sindhi females. Out of the total 800 females who attended the surgical out-patient departments of Liaqua t university medical and health sciences between March 2004- February 2006, 500 young females aged between 15-25 year were diagnosed with breast lump/lumps(with or without pain) and these were included in the study. FNAC was carried out on every patient for correct histopathological diagnosis. Out of 500 patients, 294 (59 %) had benign breast lump/lumps. Among these included 66.3% with fibrocystic disease along with adenosis; 11.5% with fibroadenoma along with adenosis; 8.1% with solitary fibroadenoma; 6.12% with unilateral multiple fibroadenomas; 3.7% with bilateral fibroadenomas; 3.4% with recurrent fibroadenomas and 0.68% patients came with stromal lumps. The results of this study suggest that the pattern of benign breast lump is changing in young Sindhi females from fibroadenomas to adenosis and fibrocystic disease.
[Show abstract][Hide abstract] ABSTRACT: Objective: To assess the applicability of Laparoscopic Cholecystectomy in Acute Cholecystitis. Design & Duration: Prospective observational study from July 2001 to June 2006. Setting: Surgical units at Liaquat University Hospital and Private Hospitals of Hyderabad. Patients: All patients with Acute Cholecystitis who underwent Laparoscopic Cholecystectomy. Methodology: All patients with acute gall bladder symptoms, irrespective of age and sex, underwent clinical evaluation and appropriate investigations. Patients with stones in the common bile duct, carcinoma gall bladder and chronic liver disease with ascites, and those who were unfit patients were excluded from this study. All patients underwent laparoscopic surgery and the outcome analyzed. Results: In this five years study 830 patients were admitted with gall stone disease. Amongst them 200 cases (24.09%) presented with acute cholecystitis; 65(32.5%) being males and 135(67.5%) females. Pain (100%), vomiting (35%) and fever (27.5%) were common symptoms at presentation. On laparoscopy, adhesions to omentum were present in 77.41% of the cases. Various grades of inflammation were noted varying from simple inflammation in 55% to necrotic patches on the gall bladder in 11%, empyema in 30% and gangrenous gall bladder in 4%. Majority (80%) of the cases underwent surgery within 48 hours of admission. Problems encountered during surgery were profuse bleeding (17%), perforation of gall bladder (11.5%), cystic duct avulsion (1.5%) and bile duct injury (1%); conversion to open surgery was resorted to in 5.5% cases. Post operative complications included bleeding (9%), vomiting (17.5%) and bile leakage (4%). The hospital stay was between 2 days to >5 days (mean stay=2.81 days). There was no mortality in this series. Conclusion: Emergency laparoscopic cholecystectomy in acute cholecystitis is safe and cost effective. However, adequate experience of the operating surgeon is mandatory.