Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 10 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Risk Factors and Complications Associated with Difficult Emergency Cholecystectomies: Experience of a Single Urban Center

Doris Sarmiento, Amber Himmler, Nube Flores, Juan Carlos Puyana, Juan Carlos Molina

Keywords : Acute cholecystitis, Biliary colic, Difficult cholecystectomy, Laparoscopic cholecystectomy, Subtotal cholecystectomy

Citation Information : Sarmiento D, Himmler A, Flores N, Puyana JC, Molina JC. Risk Factors and Complications Associated with Difficult Emergency Cholecystectomies: Experience of a Single Urban Center. Panam J Trauma Crit Care Emerg Surg 2021; 10 (1):20-25.

DOI: 10.5005/jp-journals-10030-1311

License: CC BY-NC 4.0

Published Online: 01-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: The aim and objective of this study is to determine the prevalence, risk factors, and complications of difficult cholecystectomy in our population. Materials and methods: A retrospective study was conducted from January 2016 through March 2017. Difficult cholecystectomy was the primary endpoint as defined by the surgeon in the operative report. Preoperative risk factors evaluated included: age, sex, obesity, pregnancy, resolved pancreatitis, choledocholithiasis resolved by endoscopic retrograde cholangiopancreatography (ERCP), and surgical wait time. Intraoperative factors evaluated including the presence of anatomical variants, operative time >90 minutes, and the presence of liver disease. We measured the rate of conversion from laparoscopic to open, the incidence of postoperative complications, and overall mortality in this population. Results: Of 585 patients, 77.9% were admitted for acute cholecystitis, and 22.1% for symptomatic cholelithiasis, acute pancreatitis, or choledocholithiasis treated by ERCP. The prevalence of difficult cholecystectomy in our population was 37.6%. Preoperative risk factors correlating with difficult cholecystectomy included: male sex, and age >65 years. Intraoperative risk factors included: the presence of an anatomic variant and surgical time >90 minutes. Conclusion: The prevalence of difficult emergency cholecystectomy at our institution is high. There was a low rate of complications and conversion among patients with difficult cholecystectomies.


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