Frequency of Port Site Infection in Laparoscopic Cholecystectomy, Evaluation by Southampton Score: A Prospective Study

Objective: To evaluate the frequency of Port-Site Infections (PSIs) following Laparoscopic Cholecystectomy (LC) using the Southampton Scoring System and identify associated risk factors. Methodology: This prospective cross-sectional study was conducted over two years in the Department of General Surgery at Hayatabad Medical Complex, Peshawar. Data were collected using a standardized proforma and analyzed using IBM SPSS version 23.0, with a significance value set at p<0.05. The Southampton Scoring System was used to monitor and grade wound infections at discharge, 2nd week and 4th weeks post-surgery. Results: After exclusion, 841 patients were included in the study, with 471 males (56%) and 370 females (44%). The average age was 45.9 ± 12.7 years. Significant intraoperative findings included symptomatic gallbladder stones (82.5%), acute cholecystitis (26%), thick-walled gallbladder (44.4%), bile spillage into peritoneum (41.5%), and gallbladder perforation (54.6%). The frequency of port site infection with Southampton scores of 3 and above was 9.9% for the umbilical port and 27.3% for the epigastric port. Significant risk factors for SSI included symptomatic gallbladder stones, acute cholecystitis, gangrenous gallbladder, spillage into the wound, gallbladder perforation, and surgery duration exceeding 90 minutes (p<0.05). Conclusions: The Southampton Scoring System effectively identified and tracked wound infections, underscoring the need for meticulous surgical techniques and thorough postoperative care to reduce SSIs. Although wound healing was initially good, complications increased by the 2nd and 3rd week, especially at the epigastric port. Most patients show significant improvement of wound healing by 4th week. Regular monitoring and timely interventions are essential to lower SSI rates in laparoscopic surgeries.