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Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis
BACKGROUND AND OBJECTIVES: Factors that contribute to difficult laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) that would affect the performance of early surgery remain unclear. The purpose of this study was to identify such risk factors. METHODS: One hundred fifty-four patients who u...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081400/ https://www.ncbi.nlm.nih.gov/pubmed/27807397 http://dx.doi.org/10.4293/JSLS.2016.00065 |
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author | Hayama, Satoshi Ohtaka, Kazuto Shoji, Yasuhito Ichimura, Tatsunosuke Fujita, Miri Senmaru, Naoto Hirano, Satoshi |
author_facet | Hayama, Satoshi Ohtaka, Kazuto Shoji, Yasuhito Ichimura, Tatsunosuke Fujita, Miri Senmaru, Naoto Hirano, Satoshi |
author_sort | Hayama, Satoshi |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: Factors that contribute to difficult laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) that would affect the performance of early surgery remain unclear. The purpose of this study was to identify such risk factors. METHODS: One hundred fifty-four patients who underwent LC for AC were retrospectively analyzed. The patients were categorized into early surgery and delayed surgery. Factors predicting difficult LC were analyzed for each group. The operation time, bleeding, and cases of difficult laparoscopic surgery (CDLS)/conversion rate were analyzed as an index of difficulty. Analyses of patients in the early group were especially focused on 3 consecutive histopathological phases: edematous cholecystitis (E), necrotizing cholecystitis (N), suppurative/subacute cholecystitis (S). RESULTS: In the early group, the CDLS/conversion rate was highest in necrotizing cholecystitis. Its rate was significantly higher than that of the other 2 histopathological types (N 27.9% vs E and S 7.4%; P = .037). In the delayed-surgery group, a higher white blood cell (WBC) count and older age showed significant correlations with the CDLS/conversion rate (P = .034 and P = .004). CONCLUSION: In early surgery, histopathologic necrotizing cholecystitis is a risk factor for difficult LC in AC. A higher WBC count and older age are risk factors for delayed surgery. |
format | Online Article Text |
id | pubmed-5081400 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-50814002016-11-02 Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis Hayama, Satoshi Ohtaka, Kazuto Shoji, Yasuhito Ichimura, Tatsunosuke Fujita, Miri Senmaru, Naoto Hirano, Satoshi JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Factors that contribute to difficult laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) that would affect the performance of early surgery remain unclear. The purpose of this study was to identify such risk factors. METHODS: One hundred fifty-four patients who underwent LC for AC were retrospectively analyzed. The patients were categorized into early surgery and delayed surgery. Factors predicting difficult LC were analyzed for each group. The operation time, bleeding, and cases of difficult laparoscopic surgery (CDLS)/conversion rate were analyzed as an index of difficulty. Analyses of patients in the early group were especially focused on 3 consecutive histopathological phases: edematous cholecystitis (E), necrotizing cholecystitis (N), suppurative/subacute cholecystitis (S). RESULTS: In the early group, the CDLS/conversion rate was highest in necrotizing cholecystitis. Its rate was significantly higher than that of the other 2 histopathological types (N 27.9% vs E and S 7.4%; P = .037). In the delayed-surgery group, a higher white blood cell (WBC) count and older age showed significant correlations with the CDLS/conversion rate (P = .034 and P = .004). CONCLUSION: In early surgery, histopathologic necrotizing cholecystitis is a risk factor for difficult LC in AC. A higher WBC count and older age are risk factors for delayed surgery. Society of Laparoendoscopic Surgeons 2016 /pmc/articles/PMC5081400/ /pubmed/27807397 http://dx.doi.org/10.4293/JSLS.2016.00065 Text en © 2016 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Scientific Papers Hayama, Satoshi Ohtaka, Kazuto Shoji, Yasuhito Ichimura, Tatsunosuke Fujita, Miri Senmaru, Naoto Hirano, Satoshi Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis |
title | Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis |
title_full | Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis |
title_fullStr | Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis |
title_full_unstemmed | Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis |
title_short | Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis |
title_sort | risk factors for difficult laparoscopic cholecystectomy in acute cholecystitis |
topic | Scientific Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081400/ https://www.ncbi.nlm.nih.gov/pubmed/27807397 http://dx.doi.org/10.4293/JSLS.2016.00065 |
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