Work

Preoperative systemic and local inflammation are independent risk factors for difficult laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage

Year: 2024

Type: article

Abstract: Background Laparoscopic cholecystectomy (LC) is required for acute cholecystitis patient with percutaneous transhepatic gallbladder drainage (PTGBD). However, it's unknown how to distinguishing the surgical difficulty for these patients. Methods Data of patients who underwent LC after PTGBD between 2016 and 2022 were collected. Patients were categorized into difficult and non-difficult operations based on operative time, blood loss, and surgical conversion. Performance of prediction model was evaluated by ROC, calibration, and decision curves. Results A total of 127 patients were analyzed, including 91 in non-difficult operation group and 36 in difficult operation group. Elevated CRP ( P = 0.011), pericholecystic effusion ( P < 0.001), and contact with stomach or duodenal ( P = 0.015) were independent risk factors for difficult LC after PTGBD. A nomogram was developed according to these risk factors, and was well-calibrated and good at distinguishing difficult LC after PTGBD. Conclusion Preoperative elevated systemic and local inflammation indictors are predictors for difficult LC after PTGBD.

Source: Heliyon

DOI: 10.1016/j.heliyon.2024.e36081

Authors: Hai-Hong Wei, Yu-Xiang Wang, Bin Xu, Yong-Gui Zhang

Institutions: Tongji University, Shanghai Jiao Tong University, Tongren Hospital, Shanghai Tenth People's Hospital

Language: English

Topic: Gallbladder and Bile Duct Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,100