However, we lost follow up to 21 patients (SSMPPLE group) and 19 patients (CMLC group). 3. Results 3.1. The SSMPPLE Erlotinib Group The mean operative time was 43.8min (range, 20�C85). The average blood loss was 9.4mL (range, 5�C55). There was no bile duct injury. However, we had one electrosurgical burn to the second part of the duodenum which was sutured by the intracorporeal technique. Eleven patients (3.4%) had small perforation of gallbladder while dissecting. Spilled bile was sucked and the stones were extracted before giving a thorough peritoneal irrigation with saline. Six patients (1.9%) had to be converted to 4-port CMLC. Five of them had intense pericholecystic adhesions not amenable to this technique and one had ambiguous biliovascular anatomy requiring conversion for better definition of critical structures.
Furthermore, we converted five patients to open cholecystectomy; out of these, three were due to uncontrollable cystic artery bleeds and two were due to inadvertent gallbladder fossa bleeds requiring suturing. Eleven patients from this series had low-inserting cystic ducts, 8 had their cystic ducts opening in their right hepatic ducts and 4 had their right hepatic arteries tortuously occupying the cystohepatic triangles��the ��caterpillar turns�� All the patients were allowed to have solid food by 5.7h (range, 5�C12) after the surgery and were ambulatory by then. Mean VAS applied to all the patients on the days 0, 1, 7, and 30 of the surgery was 3.2 (range, 3�C5), 2.1 (range, 1�C4), 0, and 0, respectively. Mean postoperative analgesics were used for 1.
7 days (range, 0.5�C4.8). The postoperative analgesia regimen was standardized for both the groups as follows. All the patient of this study received intravenous aqueous diclofenac sodium at the end of 6th postoperative hour before putting them on oral diclofenac sodium preparation (sustained release) the next day. None of our patients needed opioid analgesics. The patients were discharged after an average of 1.3 days (range, 1�C5). The mean time to take up normal activity was 3.2 days (range, 3�C7) (Table 2). Except 4, all other patients are under regular follow up. While the first patient of our series has finished 4 years and 9 months of follow up, the last patient has completed 1 year and 10 months of follow up. Two of the four patents lost follow up due to their demise owing to cardiac ailments.
Other two have completely lost their follow up due to the reasons unknown. Six patients (1.9%) developed umbilical sepsis which was controlled by antibiotics. Seven patients developed umbilical seroma; they recovered completely by an expectant line Drug_discovery of treatment. None of our patients has developed trocar-site hernia till date. Seven patients (4 at the end of 9 months and 4 at the end of 13 months) developed residual bile duct stones which were extracted by endoscopic sphincterotomy. Assessment by the scar grading scale revealed 73.