Gallbladder wall thickness as a predictor of intraoperative events during laparoscopic cholecystectomy: A prospective study of 1089 patients.
Am J Surg
; 220(4): 1031-1037, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-32178838
ABSTRACT
BACKGROUND:
Laparoscopic cholecystectomy (LC) has a wide range of technical difficulty. Preoperative risk stratification is essential for adequate planning and patient counseling. We hypothesized that gallbladder wall thickness (GWT) is more objective marker than symptom duration in predicting complexity, as determined by operative time (OT), intraoperative events (IE), and postoperative complications.METHODS:
All adult patients who underwent LC during 2010-2018 were included. GWT, measured on imaging and on the histopathologic exam, was divided into three groups <3 mm (normal), 3-7 mm and >7 mm. Univariate and multivariable analyses were performed to determine the association between GWT and 1) operative time, 2) the incidence of IE and 3) postoperative outcomes.RESULTS:
A total of 1089 patients, subjects to LC, were included in the study. GWT was positively correlated with median OT (p < 0.001), the incidence of IE (p < 0.001) and median length of hospital stay (p < 0.001). GWT independently predicted IE (OR = 2.1 95% CI 1.3-3.4) and outperformed symptom duration, which was not significantly associated with any of the outcomes (p = 0.7).CONCLUSIONS:
GWT independently predicted IE and may serve as an objective marker of LC complexity.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Colecistite
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Colecistectomia Laparoscópica
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Vesícula Biliar
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Complicações Intraoperatórias
Tipo de estudo:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
2020
Tipo de documento:
Article