Browsing by Author "Bhattarai, Abhishek"
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Publication Complications among Patients Undergoing Pancreaticoduodenectomy in Tertiary Care Centers of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Neupane, Harish Chandra; Tamang, Tseten Yonjen; Timalsina, Santosh; Tamrakar, Kishor Kumar; Bhattarai, AbhishekAbstract: Introduction: Pancreaticoduodenectomy (Whipple procedure), even after significant evolution, continues to be associated with a high morbidity. The study aimed to find out the prevalence of complications following pancreaticoduodenectomies performed by a single surgeon over a span of 20 years in tertiary care hospitals of Nepal. Methods: This was a descriptive cross-sectional study conducted from hospital records of patients who underwent pancreaticoduodenectomy between 1999 and 2019 at different institutions in Chitwan, where the principal author was involved. Ethical clearance was taken from the Institutional Review Committee. Convenience sampling was done. Patients’ clinical characteristics and diagnoses were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated, with frequency and percentage. Results: Out of 327 patients who underwent pancreaticoduodenectomy, complications were found in 125 (38.2%) (32.9-43.7 at 95% Confidence Interval). Respiratory complications were the commonest 32 (9.8%), followed by septicemia 25 (7.6%) and cardiac complications 24 (7.3%). Delayed gastric emptying and postoperative pancreatic fistula were seen in 11 (6.8%) and 4 (2.5%) in the first decade respectively. In the second decade, delayed gastric emptying was noted in 2 (1.2%) and postoperative pancreatic fistula in 1 (0.6%) patient. Conclusions: The prevalence of complications in our study was comparable to other national and international studies. Surgery-specific complications such as delayed gastric emptying and postoperative pancreatic fistula showed a decline over the decade.Publication Exploratory Laparotomy for Severe Dowry-related Spousal Violence Injuries in a Young Woman(Nepal Health Research Council, 2024) Sapkota, Arbin Dev; Bhattarai, Abhishek; Rimal, Sudesha; Shrestha, Roshan; Regmi, Sadikshya; Atreya, AlokThis case report highlights the severity of dowry-related intimate partner violence in Terai, Nepal. A 24-year-old married female presented with multiple stab injuries to the abdomen and a cut-throat injury inflicted by her husband under the influence of alcohol due to dissatisfaction with dowry demands. Successful management involved exploratory laparotomy, anterior abdominal wall repair, cholecystectomy, and neck injury repair. However, on the third postoperative day, due to persistent pain and feeding difficulties, the patient was referred to a tertiary care center, where a re-exploratory laparotomy revealed missed diaphragmatic injury and bowel herniation requiring further repair. This case underscores the need for high clinical suspicion and early specialist referral in complex trauma scenarios. It also highlights the role of cultural and societal factors in intimate partner violence and the need for a multidimensional approach involving healthcare, legal, and social services. Keywords: Abdominal trauma; dowry; intimate partner violence; Nepal; stab injuryPublication Open Cholecystectomy among Patients undergoing Laparoscopic Cholecystectomy in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Katwal, Gaurav; Thapa, Yeshika; Shrestha, Aisha; Bhattarai, Abhishek; Tamrakar, Kishor Kumar; Neupane, Harish ChandraAbstract Introduction: In the current era, laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstone disease. The aim of this study is to find out the prevalence of open cholecystectomy among patients undergoing laparoscopic cholecystectomy in a tertiary care centre. Methods: It is a descriptive cross-sectional study done among 345 patients at the Department of Surgery of a tertiary care centre from June, 2020 to May, 2021 after receiving ethical clearance from the Institutional Review Committee (Reference number: CMC-IRC/0770798-271). Convenience sampling was done. Successive patients who underwent elective laparoscopic cholecystectomy during the study period were included. Standard 4 port laparoscopic technique was used for the laparoscopic cholecystectomy and sub-costal Kocher incision was used for the open cholecystectomy respectively. After data collection, entry and analysis were done in Microsoft Excel. Point estimate at a 95% Confidence Interval was calculated along with frequency and percentages for binary data. Results: Out of 345 patients, the prevalence of open cholecystectomy among patients undergoing laparoscopic cholecystectomy was 6 (1.73%) (0.35-3.11 at a 95% Confidence Interval). Conclusions: This study showed that the prevalence of open cholecystectomy among patients undergoing laparoscopic cholecystectomy was lower when compared to similar studies conducted in similar settings.