Routine postoperative blood tests fail to reliably predict procedure-related complications after laparoscopic cholecystectomy.


Journal

Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 15 11 2020
accepted: 02 02 2021
pubmed: 25 3 2021
medline: 25 9 2021
entrez: 24 3 2021
Statut: ppublish

Résumé

Laparoscopic cholecystectomy is a highly standardized surgical procedure with a low risk of complications. However, once complications develop, they can be life-threatening. The aim of this study was to evaluate the value of blood tests on postoperative day one regarding their potential to predict postoperative complications METHODS: A cohort study of 1706 consecutive cholecystectomies performed at a tertiary hospital and teaching facility over a 5-year period between 2014 and 2019. Patients that had open CCE or conversion CCE were excluded. One thousand five hundred eighty-six patients were included in the final analysis that received a laparoscopic cholecystectomy (CCE). One thousand five hundred twenty-three patients had blood tests on POD 1. Forty-one complications were detected including 14 bile leaks, 2 common bile duct injuries, 13 choledocholithiasis, 9 hematomas, and 2 active bleedings. Bilirubin was elevated in 351 patients on POD 1. A drop of more than 3 mg/dl of hemoglobin was reported in 39 patients. GPT was elevated 3 × above the upper limit in 102 patients. All three tests showed a low sensitivity and specificity in detecting postoperative complications. Early postoperative blood tests alone show a low specificity in detecting postoperative complications after laparoscopic CCE. Their main benefit appears to be the negative predictive value, when they are normal. Routine blood testing appears to be unnecessary and should be based on the intraoperative diagnosis and postoperative clinical findings.

Identifiants

pubmed: 33760977
doi: 10.1007/s00423-021-02115-x
pii: 10.1007/s00423-021-02115-x
pmc: PMC8208910
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1155-1163

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Auteurs

Jens Strohäker (J)

Department of General, Visceral and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany. Jens.Strohaeker@med.uni-tuebingen.de.

Lisa Wiegand (L)

Department of General, Visceral and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

Christian Beltzer (C)

Department of General, Visceral and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

Alfred Königsrainer (A)

Department of General, Visceral and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

Ruth Ladurner (R)

Department of General, Visceral and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

Robert Bachmann (R)

Department of General, Visceral and Transplantation Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

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