Outcomes and risk factors of cholecystectomy in high risk patients: A case series.
ASA
ASA, American Society of Anaesthesia fitness classification
BMI, Body mass index
CBD, common bile duct
Cholecystectomy
ERCP, endoscopic retrograde cholangiopancreatography
GB, gallbladder
High risk surgery
ITU, Intensive Treatment Unit
Laparoscopic surgery
MRCP, magnetic resonance cholangiopancreatography
RTT, Return to theatre
WCC, White cell count
Journal
Annals of medicine and surgery (2012)
ISSN: 2049-0801
Titre abrégé: Ann Med Surg (Lond)
Pays: England
ID NLM: 101616869
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
30
08
2019
revised:
21
12
2019
accepted:
23
12
2019
entrez:
21
1
2020
pubmed:
21
1
2020
medline:
21
1
2020
Statut:
epublish
Résumé
Many studies looked at outcomes and risk factors in laparoscopic cholecystectomies in general, including a few studies on risk factors and scoring systems in predicting conversion to open surgery. Little data has been produced on high-risk patients undergoing cholecystectomy. Identifying risk factors in this group could help stratify decision making regarding best management strategies.The aim of this study was to investigate outcomes of laparoscopic cholecystectomies in patients with ASA 3 and 4. Data was collected and collated from a prospectively maintained database of all laparoscopic cholecystectomies performed by 13 general surgeons in a single unit. Case notes were reviewed for all patients with ASA 3 and 4 between 2013 and 2017. Data analysis was performed using R studio v 3.4. 244 cases were reviewed. Common bile duct was dilated in 52 cases (21.31%). Gall bladder wall was thick in 102 (41.8%) of the patients. Surgery was elective in 203 (83.2%) of the patients. ERCP was performed in 41 (16.9%) of the patients prior to surgery. 150 patients (62.2%) stayed for 1 day while 36 (14.9%) stayed for 2 days and the remaining 55 (22.9%) stayed for 3 days or more. Complications occurred in 37 (15.16%) of the patients while 23 (9.43%) of the patients were readmitted. 7 patients (2.87%) returned to theatre and 8 (3.28%) stayed in ITU post-op. Two patients died (0.82%). Laparoscopic cholecystectomies in higher risk populations are safe. Alternative methods such as cholecystostomy and ERCP may be of benefit in these patients.
Identifiants
pubmed: 31956409
doi: 10.1016/j.amsu.2019.12.003
pii: S2049-0801(20)30001-7
pmc: PMC6956681
doi:
Types de publication
Case Reports
Langues
eng
Pagination
35-40Informations de copyright
© 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
Déclaration de conflit d'intérêts
No conflict of interest.
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