48 th 49 th lap chole( 23rd in nh)

48 the lap chole operation was nicely done. But pt developed palm oedema and lvf. Eventually pt died. There was tremendous chaos after death. I had to agree to give rs 2 lakh to patient party. Dr PK Roy ,anesthesisist, agreed to share rs 50 thousand. Nursing home bore rs fifty thousand.
49 the lap chole patent was a lean and thin pt. GB was alright. Nicely operated.

Rik

Rik has done badly in exam. There are two years left before the final ., let me give a final try . I will teach him everyday. I will sit by him while he is studying. I think inattention and English language is causing the trouble for him. I shall review my attention every month.

47th and 21st lap chole

Last lap chole had a bile leak which caused a little tension. I had to take her to bmch for managing the case. She was managed conservatively. After that I had  done three lap chole. All were uneventful.

44th and 19th lap chole

Lean pt. Entry little difficult. Rest was okay. Post op pt was complaining of back and shoulder pain.

43rd and 18th lap chole

Lean , middle aged female. Entry perfect. Calot's triangle dissection was good. Liver bed dissection was quick. It took less than 1 hour. Things are improving.

Cholesteol level

For the first time cholesterol lever has shot up after ot. LDL IS 74.4. It should remain below 60. I have decided not to take anything in train. I must bring it down in three months, I have no choice. I have to do yogas regularly.

42nd and 17th lap chole

Medium built, entry okay. Calot,s triangle was easy. There was a arterial spurt from posterior side. Managed with diathermy. Rest was uneventful.