Association between Socioeconomic Factors and Postoperative Complications of Cholecystectomy

Author(s):  
Herman Romero Ramírez ◽  
Norma Muñoz Albán ◽  
Consuelo Albán Meneses ◽  
Alicia Escobar Torres

The article´s goal isto determine if socioeconomic factors influence the postoperative complications of cholecystectomy. For this, the observational study was defined, analytical and quantitative study was conducted in 100 patients who underwent cholecystectomy. A logistic regression model was applied in which risk factors, socioeconomic characteristics, along with a control variable, were incorporated as variables. Three models were run with alternative dependent variables that are delimited by the type of postoperative complication recorded. The results found showed that women show a higher risk of presenting complications after cholecystectomy, the same occurs in older patients. Likewise, the risk is much lower in people with higher education levels and in patients who underwent laparoscopic cholecystectomy, they only have a 5% risk of presenting complications. Postoperative complications after cholecystectomy are minimized by using the laparoscopic technique and socioeconomic factors would influence the risk of suffering postoperative complications after said surgery, which makes laparoscopic cholecystectomy a safe operation with many other benefits and advantages over traditional or conventional surgery.

2012 ◽  
Vol 8 (4) ◽  
pp. 367-369 ◽  
Author(s):  
B R Malla ◽  
R K M Shrestha

Background Laparoscopic cholecystectomy has become standard method for treating gallstone. However, different centres have reported different complications and conversion rate. The objective of this study was to evaluate complications and conversion of laparoscopic cholecystectomy into open cholecystectomy in Dhulikhel Hospital, Kathmandu University, Nepal. Methods Files of all patients who had laparoscopic cholecystectomy from January 2005 to December 2009 were reviewed. Out of 119 laparoscopic cholecystectomy cases, 102 were included in the study as complete information was lacking in the rest. Results Out of 102 cases, 80 were female. Symptomatic cholelithiasis were 76.47%. The mean hospital stay was 2.48 days. Postoperative complications occured in 5.88% patients. Conversion rate to open cholecystectomy was 3.92%. Conclusions Laparoscopic cholecystectomy is a reliable and safe surgery. With growing experience in laparoscopic technique, it is possible to bring complications and conversion rate to minimum. However, there will be no significant improvements once learning curve is reached. Rather, the nature of biliary injury may become more severe.http://dx.doi.org/10.3126/kumj.v8i4.6232 Kathmandu Univ Med J 2010;8(4):367-9


HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.


2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Adam Bobkiewicz ◽  
łukasz Krokowicz ◽  
Tomasz Banasiewicz ◽  
Tomasz Kościński ◽  
Maciej Borejsza-Wysocki ◽  
...  

AbstractIatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased.was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014.. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay.. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%).. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.


2017 ◽  
Vol 5 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Tapash Kumar Maitra ◽  
Mahmud Ekram Ullah ◽  
Faruquzzaman ◽  
Samiran Kumar Mondol

Background: The technique of laparoscopic surgery has rapidly become popular because of its several advantages over conventional open surgery. The reduction of postoperative pain provided positive human impact, and the reduction of length of hospital stay as well as the earlier return to work generated a positive socioeconomic impact. However, in spite of being a minimally invasive technique, this procedure has different peroperative and postoperative complications which cannot be disregarded.Objective: To evaluate the complications of laparoscopic cholecystectomy in symptomatic and asymptomatic cholelithiasis and other benign gall bladder diseases.Methodology: 172 patients who underwent laparoscopic cholecystectomy were included in this prospective study on the basis of non-randomized convenient sampling from a period of September 30, 2014 to September 30, 2016 in BIRDEM General Hospital, Dhaka, Bangladesh. Data of the patients regarding outcomes and complications were analyzed.Result: Results of this study suggests that 35.5% cases were male and 64.5% patients were female. In male group, most of the patients (18.0%) were in 41-50 years of age group followed by 9.9% in 51-60 years age group, whereas among the female patients these were 33.1% and 15.7% respectively. Mean±SD of age were46±1.7 and 42±1.3 years in case of male and female patients respectively.In 119 (69.2%) out of total 172 cases, laparoscopic cholecystectomy was done for chronic cholecystitis and in 18.6% (32 out of total 172) cases, it was performed for acute cholecystitis. Intra-operative bile leak(11.0%) was found to be the most frequent complications during laparoscopic cholecystectomy. The incidence rates of perforation of gall bladder, stone spillage were 9.3% and 5.2% respectively. Trocar site, vascular, and hepatic bed hemorrhages were 7.0%, 4.7% and 4.0% respectively. Open conversion was done in 17 cases (9.9%). Port site infection and post cholecystectomy syndrome developed in 5.2% and 4.7% cases respectively. The overall mortality was approximately 1.1%. Serious complications likebowel injury and bile duct injury were recorded in 0.6% and 1.2% cases respectively.The results of this study suggest that gender, age, co-morbidities, previous abdominal surgery, acute cholecystitis, obesity, thickened gall bladder wall on ultrasound, history of preoperative ERCPare probablyimportant and clinically significant relevant factors for open conversion of laparoscopic cholecystectomy.Conclusion: In our study, complications of laparoscopic cholecystectomy were similar to those of different centres in western countries. We found laparoscopic cholecystectomy as a safe and effective procedure in almost all patients with cholelithiasis. Proper preoperative work up, awareness of possible complications and adequate training on laparoscopic technique make this operation a safe procedure with favorable result and lesser complications.Bangladesh Crit Care J March 2017; 5(1): 11-16


2018 ◽  
Vol 46 (6) ◽  
pp. 631-639
Author(s):  
E. A. Galliamov ◽  
R. G. Biktimirov ◽  
V. P. Sergeev ◽  
L. N. Aminova ◽  
A. E. Sanzharov ◽  
...  

Background: Laparoscopic surgery has proved itself to be a “golden standard” for treatment of most abdominal and retroperitoneal cancers. Such a serious procedure as pelvic exenteration continues to be a complex surgical intervention usually performed through a  conventional laparotomic access. However, studies on minimally invasive approach for this intervention have becoming increasingly published in the world literature.Aim: To describe the laparoscopic pelvic exenteration technique of pelvic exenteration, as well as to assess short- and long-term results of these interventions.Materials and methods: From 2011 to 2018, 21 procedures of laparoscopic pelvic exenteration have been performed in 6  surgical centers (Moscow, Russia). Six (6) patients had previously confirmed cervical cancer, 7 patients had bladder cancer, 4 patients had rectal cancer, 1 patient had vaginal cancer, 2 patients had relapsing vaginal cancers after previous uterine extirpation, and 1 patient had an ovarian neoplasm.Results: The laparoscopic pelvic exenteration volumes were as follows: 9  total, 7 anterior and 5 posterior procedures. In 19 out of 21 cases, negative resection margin (R0) was possible. Median duration of the procedure was 254 minutes, median blood loss was 515 ml, and median postoperative hospital stay was 13 days. Postoperative complications were registered in 6 (28.6%) patients. The 3-year overall survival was 85.71%.Сonclusion: The choice of laparoscopic access can reduce blood loss, decrease the rates of early postoperative complications, contributes to a more comfortable postoperative period with early activation and less severe pain syndrome, and leads to a reduction in the duration of hospital stay. These results of the laparoscopic technique are comparable with those of laparoscopic and open pelvic exenteration published by other authors.


2007 ◽  
Vol 15 (spe) ◽  
pp. 762-767 ◽  
Author(s):  
Maria de Lourdes Sperli Geraldes Santos ◽  
Silvia Helena Figueiredo Vendramini ◽  
Claudia Eli Gazetta ◽  
Sonia Aparecida Cruz Oliveira ◽  
Tereza Cristina Scatena Villa

This study aimed to evaluate the epidemiological status of Tuberculosis regarding to the socioeconomic characteristics of São José do Rio Preto between 1998 and 2004. Indexes estimated for 432 urban census tracts from the demographic census of 2000, sorted systematically according to the values of socioeconomic factors and grouped into quartiles were taken into account. The socioeconomic characterization was outlined based on Schooling, Income, and Number of Residents. The incidence rates were considered for 1998, 1999, 2003, and 2004. The socioeconomic factor accounted for 87% of the total variation. The disease prevalence is higher in the poorest areas. The incidence rate and the risk of being infected by TB in the poorest areas declined in 2003 and 2004. The results confirm that TB is determined by the population's living conditions in the city studied. It strengthens the relevance of understanding the TB conditional social factors to transform the worrisome scenario in which this population is inserted.


Author(s):  
Nidya Fahima ◽  
Sri Maemunah Soeharto ◽  
Chorry Sulistyowati

This study is an empirical testing of equity market timing and capital structure at firms which are doing IPO 2001 and 2002. The aims of this study are to test about the effect of equity market timing to capital structure and to test the persistency of the effect of equity market timing to firm’s capital structure in Indonesia. This study also used control variable, that asset tangibility, size and profitability. To analyze the data, this study used multiple regressions with SPSS 16.0 to test independent and dependent variables. The result suggest that the equity market timing has not significantly negative effect to the firms’ capital structure which used IPO 2001 and 2002 that are listed in BEI, and the effect of equity market timing to the firms’ capital structure are not persistent that the negative effect of equity market timing to the firms’ capital structure disappear within third years after IPO.


2004 ◽  
Vol 14 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Manousos M. Konstadoulakis ◽  
Pantelis T. Antonakis ◽  
George Karatzikos ◽  
Nikolaos Alexakis ◽  
Emmanuel Leandros

2014 ◽  
Vol 99 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Alper Bilal Özkardeş ◽  
Mehmet Tokaç ◽  
Ersin Gürkan Dumlu ◽  
Birkan Bozkurt ◽  
Ahmet Burak Çiftçi ◽  
...  

Abstract We aimed to compare the clinical outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Sixty patients with acute cholecystitis were randomized into early (within 24 hours of admission) or delayed (after 6–8 weeks of conservative treatment) laparoscopic cholecystectomy groups. There was no significant difference between study groups in terms of operation time and rates for conversion to open cholecystectomy. On the other hand, total hospital stay was longer (5.2 ± 1.40 versus 7.8 ± 1.65 days; P = 0.04) and total costs were higher (2500.97 ± 755.265 versus 3713.47 ± 517.331 Turkish Lira; P = 0.03) in the delayed laparoscopic cholecystectomy group. Intraoperative and postoperative complications were recorded in 8 patients in the early laparoscopic cholecystectomy group, whereas no complications occurred in the delayed laparoscopic cholecystectomy group (P = 0.002). Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay and lower cost.


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