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Kolesistektomide morbiditesi olan ve olmayan gruplar arasındaki farklar

Year 2021, Volume: 46 Issue: 3, 1077 - 1085, 30.09.2021

Abstract

Amaç: Bu çalışmada Kolesistektomi olgularında postoperatif komplikasyon gelişen hastalar ile postoperatif komplikasyon gelişmeyen hastalar arasındaki farkları belirlemek ve komplikasyonlar açısından dikkat edilmesi gereken parametreleri tanımlanması amaçlanmıştır.
Gereç ve Yöntem: Ocak 2019-Temmuz 2020 tarihleri arasında Iğdır Devlet Hastanesi'nde kolesistektomi yapılan hastalar retrospektif olarak belirlendi. Hastaların genel özellikleri tıbbi kayıtlarından alındı. Ameliyat sonrası 30 gün içinde komplikasyon gelişen hastalar morbidite pozitif grup, komplikasyon gelişmeyen hastalar morbidite negatif grup olarak kabul edildi. İki grup arasındaki farklar değerlendirildi.
Bulgular: Çalışmaya 108 hasta dahil edildi. Hastaların yaş ortalaması 46.44 (dağılım: 18-83) ve 85'i (%78.7) kadındı. Erkek cinsiyet, 40 yaş üstü, ameliyat öncesi ateş ile ultrasonografide (USG) hemanjiyom varlığı ve ipek ile kistik kanal kapatma artan morbidite ile ilişkiliydi. İlginç bir şekilde, aynı ameliyatta göbek fıtığı onarımı azalmış morbidite ile ilişkilendirildi.
Sonuç: Bu çalışma kolesistektomi hastalarında erkek cinsiyet, ileri yaş ve ameliyat öncesi ateş artmış morbidite ile ilişkili olduğunu bulmuştur. Preoperatif hemanjiyom varlığı artmış morbidite ile ilişkili yeni bir parametredir. Ayrıca kolesistektomi sırasında sistik kanal kapatılırken ipek sütür kullanılmamasını ve varsa göbek fıtığı tamir edilmesini öneriyoruz.

References

  • 1. Di Ciaula A, Portincasa P. Recent advances in understanding and managing cholesterol gallstones. F1000Res. 2018;7.
  • 2. Chen X, Yan X-R, Zhang L-P. Ursodeoxycholic acid after common bile duct stones removal for prevention of recurrence: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97.
  • 3. Kurzweil A, Martin J. Transabdominal Ultrasound. 2018.https://www.ncbi.nlm.nih.gov/books/NBK534813/ (accessed May 2021).
  • 4. Chung AYA, Duke MC. Acute biliary disease. Surg Clin North Am. 2018;98:877-894.
  • 5. Turkoglu S, Goya C, Kalayci T. Direct X-ray and CT Findings of GallStone Ileus. Indian J Surg. 2020:1-3.
  • 6. Mulholland MW, Lillemoe KD, Doherty GM, Maier RV, Simeone DM, Upchurch GR. Greenfield's surgery: Scientific principles & practice: Lippincott Williams & Wilkins; 2012.
  • 7. Strasberg SM. Acute calculous cholecystitis. N Engl J Med. 2008;358:2804-11.
  • 8. Loozen CS, van Ramshorst B, van Santvoort HC, Boerma D. Early cholecystectomy for acute cholecystitis in the elderly population: a systematic review and meta-analysis. Dig Surg. 2017;34:371-9.
  • 9. Kamarajah SK, Karri S, Bundred JR, Evans RP, Lin A, Kew T, et al. Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis. Surg Endosc. 2020:1-14.
  • 10. Annamaneni R, Moraitis D, Cayten C. Laparoscopic cholecystectomy in the elderly. JSLS. 2005;9:408.
  • 11. Kaya IO, Ozkardes A, Ozdemir F, Seker G, Tokac M, Ozmen MM. Laparoscopic cholecystectomy in elderly people: does advanced age present any risk for conversion? J Am Geriatr Soc. 2008;56:962-3.
  • 12. do Amaral PCG, de Medeiros Azaro Filho E, Galvao TD, de Menezes Ettinger JEM, Reis JMS, Lima M, et al. Laparoscopic cholecystectomy for acute cholecystitis in elderly patients. JSLS. 2006;10:479.
  • 13. Kanakala V, Borowski DW, Pellen MG, Dronamraju SS, Woodcock SA, Seymour K, et al. Risk factors in laparoscopic cholecystectomy: a multivariate analysis. Int J Surg. 2011;9:318-23.
  • 14. Kama N, Doganay M, Dolapci M, Reis E, Atli M, Kologlu M. Risk factors resulting in conversion of laparoscopic cholecystectomy to open surgery. Surg Endosc. 2001;15:965-8.
  • 15. Pavlidis TE, Marakis GN, Ballas K, Symeonidis N, Psarras K, Rafailidis S, et al. Risk factors influencing conversion of laparoscopic to open cholecystectomy. JLaparoendosc Adv Surg Tech A. 2007;17:414-8.
  • 16. Ibrahim S, Hean TK, Ho LS, Ravintharan T, Chye TN, Chee CH. Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World JSurg. 2006;30:1698-704.
  • 17. Lein H-H, Huang C-S. Male gender: risk factor for severe symptomatic cholelithiasis. World JSurg. 2002;26:598-601.
  • 18. Brodsky A, Matter I, Sabo E, Cohen A, Abrahamson J, Eldar S. Laparoscopic cholecystectomy for acute cholecystitis: can the need for conversion and the probability of complications be predicted? Surg Endosc. 2000;14:755-60.
  • 19. Yol S, Kartal A, Vatansev C, Aksoy F, Toy H. Sex as a factor in conversion from laparoscopic cholecystectomy to open surgery. JSLS. 2006;10:359.
  • 20. Dolan JP, Diggs BS, Sheppard BC, Hunter JG. The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997–2006. J Gastrointest Surg. 2009;13:2292.
  • 21. Roslyn JJ, Binns GS, Hughes E, Saunders-Kirkwood K, Zinner MJ, Cates JA. Open cholecystectomy. A contemporary analysis of 42,474 patients. Ann Surg. 1993;218:129.
  • 22. Brunt L, Quasebarth M, Dunnegan D, Soper N. Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly. Surg Endosc. 2001;15:700-5.
  • 23. Yang TF, Guo L, Wang Q. Evaluation of Preoperative Risk Factor for Converting Laparoscopic to Open Cholecystectomy: A Meta-Analysis. Hepatogastroenterology. 2014;61:958-65.
  • 24. Sakalar S, Ozakın E, Cevik AA, Acar N, Dogan S, Kaya FB, et al. Plasma Procalcitonin Is Useful for Predicting the Severity of Acute Cholecystitis. Emerg Med Int.2020.
  • 25. Halachmi S, DiCastro N, Matter I, Cohen A, Sabo E, Mogilner JG, et al. Laparoscopic cholecystectomy for acute cholecystitis: how do fever and leucocytosis relate to conversion and complications? Eur JSurg. 2000;166:136-40.
  • 26. Bedirli A, Sakrak O, Sözüer EM, Kerek M, Güler I. Factors effecting the complications in the natural history of acute cholecystitis. Hepatogastroenterology. 2001;48:1275-8.
  • 27. Vatansev C, Kartal A, Calayan O, Vatansev H, Yol S, Tekin A, editors. Why is the conversion rate to open surgery during cholecystectomy higher in men than in women. Proceedings of the Turkish National Surgery Congress, Turkey; 2002.
  • 28. Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am JSurg. 2002;184:254-8.
  • 29. Kumar A, Mohan M, Pandey C. Factors Responsible for Conversion of Laparoscopic to Open Cholecystectomy.Int J Med Surg Radiol.2020;5:54-57.
  • 30. Gholipour C, Fakhree MBA, Shalchi RA, Abbasi M. Prediction of conversion of laparoscopic cholecystectomy to open surgery with artificial neural networks. BMC Surg. 2009;9:1-6.
  • 31. Srikantegowda H, Ponsingh S, Patel S, Nithin K. Reasons and Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy: A Retrospective Analysis in an Urban Teaching Hospital. Int J Ana Radiol Surg. 2020;9:1-4.
  • 32. Kirshtein B, Bayme M, Bolotin A, Mizrahi S, Lantsberg L. Laparoscopic cholecystectomy for acute cholecystitis in the elderly: is it safe? Surg Laparosc EndoscPercutan Tech. 2008;18:334-9.
  • 33. Keus F, de Jong J, Gooszen H, Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane database of Sys Rev. 2006:4.
  • 34. Ermilychev A, Kravchenko V, Popenko G. Technical aspects of laparoscopic cholecystectomy in umbilical hernia. Klin Khir. 2004:8-10.
  • 35. AlMarzooqi R, Tish S, Tastaldi L, Fafaj A, Olson M, Stewart T, et al. Is concomitant cholecystectomy safe during abdominal wall reconstruction? An AHSQC analysis. Hernia. 2020:1-9.
  • 36. Bali S, Singal R. Laparoscopic suturing versus clip application in cholecystectomy: Tips and strategies for improving efficiency and safety. Acta Gastroenterol Latinoam. 2018;48:35-40.
  • 37. Ozer MT, Sinan H, Kilbas Z, Coskun AK, Gunal A, Demirbas S, et al. Comparison of Different Cystic Duct Closure Methods in Laparoscopic Cholecystectomy: Silk Suture, Surgical Clip, Harmonic Scalpel and PlasmaKinetic. Arch Clin Exp Surg. 2012;1:168-71.
  • 38. Shah J, Maharjan S. Clipless laparoscopic cholecystectomy-a prospective observational study. Nepal Med Coll J. 2010;12:69-71.

Differences between groups with and without morbidity in cholecystectomy

Year 2021, Volume: 46 Issue: 3, 1077 - 1085, 30.09.2021

Abstract

Purpose: The aim of this study was to determine the differences between the patients with postoperative complications and the patients without postoperative complications in cholecystectomy cases and to identify parameters that should be considered regarding complications.
Materials and Methods: Patients who underwent cholecystectomy between January 2019 and July 2020 at Igdir State Hospital, Igdir, Turkey were identified retrospectively. The patients’ general characteristics were retrieved from their medical records. Patients who developed complications in the 30 days after surgery were considered the morbidity-positive group, and the patients without complications were considered the morbidity-negative group. The differences between the two groups were evaluated.
Results: The study included 108 patients. The patients’ mean age was 46.44 years (range: 18‒83), and 85 (78.7%) were women. Male gender, age over 40 years, preoperative fever with the presence of haemangioma on ultrasonography (USG) and cystic canal closure using silk were associated with increased morbidity. Interestingly, umbilical hernia repair in the same surgery was associated with reduced morbidity.
Conclusion: This study found that male gender, older age, and preoperative fever were associated with increased morbidity in cholecystectomy patients. Presence of preoperative haemangioma is a new parameter associated with increased morbidity. In addition, we recommend using silk sutures when closing the cystic duct during cholecystectomy and repairing the umbilical hernia, if present.

References

  • 1. Di Ciaula A, Portincasa P. Recent advances in understanding and managing cholesterol gallstones. F1000Res. 2018;7.
  • 2. Chen X, Yan X-R, Zhang L-P. Ursodeoxycholic acid after common bile duct stones removal for prevention of recurrence: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97.
  • 3. Kurzweil A, Martin J. Transabdominal Ultrasound. 2018.https://www.ncbi.nlm.nih.gov/books/NBK534813/ (accessed May 2021).
  • 4. Chung AYA, Duke MC. Acute biliary disease. Surg Clin North Am. 2018;98:877-894.
  • 5. Turkoglu S, Goya C, Kalayci T. Direct X-ray and CT Findings of GallStone Ileus. Indian J Surg. 2020:1-3.
  • 6. Mulholland MW, Lillemoe KD, Doherty GM, Maier RV, Simeone DM, Upchurch GR. Greenfield's surgery: Scientific principles & practice: Lippincott Williams & Wilkins; 2012.
  • 7. Strasberg SM. Acute calculous cholecystitis. N Engl J Med. 2008;358:2804-11.
  • 8. Loozen CS, van Ramshorst B, van Santvoort HC, Boerma D. Early cholecystectomy for acute cholecystitis in the elderly population: a systematic review and meta-analysis. Dig Surg. 2017;34:371-9.
  • 9. Kamarajah SK, Karri S, Bundred JR, Evans RP, Lin A, Kew T, et al. Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis. Surg Endosc. 2020:1-14.
  • 10. Annamaneni R, Moraitis D, Cayten C. Laparoscopic cholecystectomy in the elderly. JSLS. 2005;9:408.
  • 11. Kaya IO, Ozkardes A, Ozdemir F, Seker G, Tokac M, Ozmen MM. Laparoscopic cholecystectomy in elderly people: does advanced age present any risk for conversion? J Am Geriatr Soc. 2008;56:962-3.
  • 12. do Amaral PCG, de Medeiros Azaro Filho E, Galvao TD, de Menezes Ettinger JEM, Reis JMS, Lima M, et al. Laparoscopic cholecystectomy for acute cholecystitis in elderly patients. JSLS. 2006;10:479.
  • 13. Kanakala V, Borowski DW, Pellen MG, Dronamraju SS, Woodcock SA, Seymour K, et al. Risk factors in laparoscopic cholecystectomy: a multivariate analysis. Int J Surg. 2011;9:318-23.
  • 14. Kama N, Doganay M, Dolapci M, Reis E, Atli M, Kologlu M. Risk factors resulting in conversion of laparoscopic cholecystectomy to open surgery. Surg Endosc. 2001;15:965-8.
  • 15. Pavlidis TE, Marakis GN, Ballas K, Symeonidis N, Psarras K, Rafailidis S, et al. Risk factors influencing conversion of laparoscopic to open cholecystectomy. JLaparoendosc Adv Surg Tech A. 2007;17:414-8.
  • 16. Ibrahim S, Hean TK, Ho LS, Ravintharan T, Chye TN, Chee CH. Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World JSurg. 2006;30:1698-704.
  • 17. Lein H-H, Huang C-S. Male gender: risk factor for severe symptomatic cholelithiasis. World JSurg. 2002;26:598-601.
  • 18. Brodsky A, Matter I, Sabo E, Cohen A, Abrahamson J, Eldar S. Laparoscopic cholecystectomy for acute cholecystitis: can the need for conversion and the probability of complications be predicted? Surg Endosc. 2000;14:755-60.
  • 19. Yol S, Kartal A, Vatansev C, Aksoy F, Toy H. Sex as a factor in conversion from laparoscopic cholecystectomy to open surgery. JSLS. 2006;10:359.
  • 20. Dolan JP, Diggs BS, Sheppard BC, Hunter JG. The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997–2006. J Gastrointest Surg. 2009;13:2292.
  • 21. Roslyn JJ, Binns GS, Hughes E, Saunders-Kirkwood K, Zinner MJ, Cates JA. Open cholecystectomy. A contemporary analysis of 42,474 patients. Ann Surg. 1993;218:129.
  • 22. Brunt L, Quasebarth M, Dunnegan D, Soper N. Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly. Surg Endosc. 2001;15:700-5.
  • 23. Yang TF, Guo L, Wang Q. Evaluation of Preoperative Risk Factor for Converting Laparoscopic to Open Cholecystectomy: A Meta-Analysis. Hepatogastroenterology. 2014;61:958-65.
  • 24. Sakalar S, Ozakın E, Cevik AA, Acar N, Dogan S, Kaya FB, et al. Plasma Procalcitonin Is Useful for Predicting the Severity of Acute Cholecystitis. Emerg Med Int.2020.
  • 25. Halachmi S, DiCastro N, Matter I, Cohen A, Sabo E, Mogilner JG, et al. Laparoscopic cholecystectomy for acute cholecystitis: how do fever and leucocytosis relate to conversion and complications? Eur JSurg. 2000;166:136-40.
  • 26. Bedirli A, Sakrak O, Sözüer EM, Kerek M, Güler I. Factors effecting the complications in the natural history of acute cholecystitis. Hepatogastroenterology. 2001;48:1275-8.
  • 27. Vatansev C, Kartal A, Calayan O, Vatansev H, Yol S, Tekin A, editors. Why is the conversion rate to open surgery during cholecystectomy higher in men than in women. Proceedings of the Turkish National Surgery Congress, Turkey; 2002.
  • 28. Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am JSurg. 2002;184:254-8.
  • 29. Kumar A, Mohan M, Pandey C. Factors Responsible for Conversion of Laparoscopic to Open Cholecystectomy.Int J Med Surg Radiol.2020;5:54-57.
  • 30. Gholipour C, Fakhree MBA, Shalchi RA, Abbasi M. Prediction of conversion of laparoscopic cholecystectomy to open surgery with artificial neural networks. BMC Surg. 2009;9:1-6.
  • 31. Srikantegowda H, Ponsingh S, Patel S, Nithin K. Reasons and Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy: A Retrospective Analysis in an Urban Teaching Hospital. Int J Ana Radiol Surg. 2020;9:1-4.
  • 32. Kirshtein B, Bayme M, Bolotin A, Mizrahi S, Lantsberg L. Laparoscopic cholecystectomy for acute cholecystitis in the elderly: is it safe? Surg Laparosc EndoscPercutan Tech. 2008;18:334-9.
  • 33. Keus F, de Jong J, Gooszen H, Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane database of Sys Rev. 2006:4.
  • 34. Ermilychev A, Kravchenko V, Popenko G. Technical aspects of laparoscopic cholecystectomy in umbilical hernia. Klin Khir. 2004:8-10.
  • 35. AlMarzooqi R, Tish S, Tastaldi L, Fafaj A, Olson M, Stewart T, et al. Is concomitant cholecystectomy safe during abdominal wall reconstruction? An AHSQC analysis. Hernia. 2020:1-9.
  • 36. Bali S, Singal R. Laparoscopic suturing versus clip application in cholecystectomy: Tips and strategies for improving efficiency and safety. Acta Gastroenterol Latinoam. 2018;48:35-40.
  • 37. Ozer MT, Sinan H, Kilbas Z, Coskun AK, Gunal A, Demirbas S, et al. Comparison of Different Cystic Duct Closure Methods in Laparoscopic Cholecystectomy: Silk Suture, Surgical Clip, Harmonic Scalpel and PlasmaKinetic. Arch Clin Exp Surg. 2012;1:168-71.
  • 38. Shah J, Maharjan S. Clipless laparoscopic cholecystectomy-a prospective observational study. Nepal Med Coll J. 2010;12:69-71.
There are 38 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Tolga Kalaycı 0000-0002-6977-1757

Publication Date September 30, 2021
Acceptance Date June 22, 2021
Published in Issue Year 2021 Volume: 46 Issue: 3

Cite

MLA Kalaycı, Tolga. “Differences Between Groups With and Without Morbidity in Cholecystectomy”. Cukurova Medical Journal, vol. 46, no. 3, 2021, pp. 1077-85.