scholarly journals Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

2016 ◽  
Vol 4 (4) ◽  
pp. 641-646 ◽  
Author(s):  
Miodrag Radunovic ◽  
Ranko Lazovic ◽  
Natasa Popovic ◽  
Milorad Magdelinic ◽  
Milutin Bulajic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Biliary Duct ◽  
Blood Cell Count ◽  
Complications Of Laparoscopic Cholecystectomy

AIM: The aim of this study was to evaluate the intraoperative and postoperative complications of laparoscopic cholecystectomy, as well as the frequency of conversions. MATERIAL AND METHODS: Medical records of 740 patients who had laparoscopic cholecystectomy were analysed retrospectively. We evaluated patients for the presence of potential risk factors that could predict the development of complications such as age, gender, body mass index, white blood cell count and C-reactive protein (CRP), gallbladder ultrasonographic findings, and pathohistological analysis of removed gallbladders. The correlation between these risk factors was also analysed. RESULTS: There were 97 (13.1%) intraoperative complications (IOC). Iatrogenic perforations of a gallbladder were the most common complication - 39 patients (5.27%). Among the postoperative complications (POC), the most common ones were bleeding from abdominal cavity 27 (3.64%), biliary duct leaks 14 (1.89%), and infection of the surgical wound 7 patients (0.94%). There were 29 conversions (3.91%). The presence of more than one complication was more common in males (OR = 2.95, CI 95%, 1.42-4.23, p < 0.001). An especially high incidence of complications was noted in patients with elevated white blood cell count (OR = 3.98, CI 95% 1.68-16.92, p < 0.01), and CRP (OR = 2.42, CI 95% 1.23-12.54, p < 0.01). The increased incidence of complications was noted in patients with ultrasonographic finding of gallbladder empyema and increased thickness of the gallbladder wall > 3 mm (OR = 4.63, CI 95% 1.56-17.33, p < 0.001), as well as in patients with acute cholecystitis that was confirmed by pathohistological analysis (OR = 1.75, CI 95% 2.39-16.46, p < 0.001).CONCLUSION: Adopting laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of the hospital stay. It is important recognising IOC complications during the surgery so they are taken care of in a timely manner during the surgical intervention. Conversion should not be considered a complication. 

scholarly journals The Characteristics of Laboratory Tests at Admission and the Risk Factors for Adverse Clinical Outcomes of Severe and Critical COVID-19

2020 ◽  
Author(s):  
Liulin Wang ◽  
Xiaobin Cheng ◽  
Qiufen Dong ◽  
Chenliang Zhou ◽  
Yeming Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Proportional Hazard ◽  
Blood Cell Count ◽  
Patient Death ◽  
Cox Proportional Hazard ◽  
Independent Risk Factors

Abstract Background COVID-19 is a worldwide pandemic. In this study, we aimed to evaluate the risk of death from severe and critical COVID-19. Method A retrospective study of patients diagnosed with severe and critical COVID-19 from four hospitals , describing the clinical characteristics and laboratory results, and using Cox survival analysis to study the risk factors was conducted. Results Four hundred and forty-six patients with COVID-19 showed a high mortality rate (20.2%). All patients required oxygen therapy, and 52(12%) patients required invasive mechanical ventilation, of which 50(96%) patients died. The univariate Cox proportional hazard model showed a white blood cell count of more than 10 × 10⁹/L （HR4.3, 95% CI 2.8 to6.9）,which is a risk factor .The multivariate Cox proportional hazard model demonstrated that advanced age (HR 1.1, 95% CI 1.0 to 1.1) and high white blood cell count on admission (HR 1.1, 95% CI 1.0 to 1.2) were independent risk factors for patient death. Conclusions COVID-19 is a new disease entity that carries significant risk of morbidity and mortality.Advanced age and high white blood cell count were found to be independent risk factors for patient death.

Admission Variables Predictive of Gangrenous Cholecystitis

2012 ◽  
Vol 78 (10) ◽  
pp. 1075-1078 ◽  
Author(s):  
Ann E. Falor ◽  
Michael Zobel ◽  
Amy Kaji ◽  
Angela Neville ◽  
Christian De Virgilio
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Cell ◽  
Acute Cholecystitis ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Open Cholecystectomy ◽  
Blood Cell Count ◽  
Factors Associated ◽  
Gangrenous Cholecystitis

The objective of the present study was to identify admission clinical factors associated with gangrenous cholecystitis (GC) and factors associated with conversion to open cholecystectomy. We retrospectively evaluated 391 patients over a 17-month period who underwent urgent laparoscopic cholecystectomy for a diagnosis of acute cholecystitis. Eighty-nine patients with pathologically proven GC were compared with 302 patients without GC. On multivariable logistic regression, predictors of GC included male gender, white blood cell count greater than 14,000/mm3, heart rate greater than 90 beats per minute, and sodium 135 mg/dL or less. Conversion rate to open cholecystectomy was 7.9 per cent overall, 4 per cent for non-GC, and 19 per cent for GC (odds ratio, 0.2; 95% confidence interval, 0.1 to 0.4; P < 0.00001). Conversion was predicted by increasing number of days to surgery, total bilirubin, and white blood cell count. Complication rate was higher in the GC group (10.1 vs 3.6% in the acute cholecystitis group, P = 0.01). The increased rate of conversion observed with surgery delay suggests that early laparoscopic cholecystectomy may be preferable in most patients.

The white blood cell count: Relationships to other cardiovascular risk factors in healthy men

1995 ◽  
Vol 115 ◽  
pp. S105
Author(s):  
M. Cigolini ◽  
G. Targher ◽  
M. Tonoli ◽  
G. Agostino ◽  
F. Filippi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Blood Cell ◽  
Cardiovascular Risk Factors ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Blood Cell Count ◽  
Healthy Men

scholarly journals Gangrenous Cholecystitis: Mortality and Risk Factors

2015 ◽  
Vol 100 (2) ◽  
pp. 254-260 ◽  
Author(s):  
Akın Önder ◽  
Murat Kapan ◽  
Burak Veli Ülger ◽  
Abdullah Oğuz ◽  
Ahmet Türkoğlu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Cell ◽  
Hospital Admission ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Delay Time ◽  
Blood Cell Count ◽  
Factors Affecting ◽  
Gangrenous Cholecystitis

As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21–88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P &lt; 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.

Sign in / Sign up

Export Citation Format

Share Document