Outcome analysis of laparoscopic cholecystectomy in patients 65 years and older

Özkan, Erkan; Yıldız, Mehmet Kamil; Çakır, Tuğrul; Günay, Emre; Eris, Cengiz; Dulundu, Ender; Topaloğlu, Ümit

doi:10.5097/1300-0705.ucd.1587-12.02

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…13,14 However, there also are publications stating that it is not a risk factor. 15,16 In our study, we determined that prior abdominal surgery was not a risk factor but an adhesion makes dissection in Calot's triangle more difficult and this is a risk factor for conversion to open surgery (p < 0.05).…”

Section: Discussionmentioning

confidence: 82%

Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Ekici¹,

Tatlı²,

Kanlıöz³

2019

Adv Clin Exp Med

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Ekici U, Tatlı F, Kanlıöz M. Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery. AbstractBackground. Laparoscopic cholecystectomy (LC) is nowadays the gold standard in the surgical treatment of cholelithiasis and gallbladder diseases. But sometimes it may be inevitable to convert it to open surgery to safely end the procedure.Objectives. In this study, we aimed to investigate the risk factors for conversion to open surgery from LC.Material and methods. The records of patients that underwent LC in Malatya State Hospital (Malatya, Turkey) between January 2013 and May 2014 were prospectively examined. One hundred and forty-five patients were involved in this study. The patients were divided into 2 groups: LC patients and patients converted to open surgery. For the patients in both groups, the preoperative age, gender, body mass index (BMI), disease history, previous abdominal operations, and preoperative laboratory findings were recorded, as well as the fact if the abdominal ultrasonography (US) and endoscopic retrograde cholangiopancreatography (ERCP) were performed. Results.Of 145 patients involved in this study, 127 (87.5%) were female and 18 (12.5%) were male; their mean age was 46.54 years. Nineteen of the patients were operated on after ERCP due to acute cholecystitis and 6 patients were operated on after ERCP due to choledocholithiasis. In 134 of the patients (92.4%), the operations were completed laparoscopically, while the process was converted to open surgery in 11 cases (7.6%). Male gender, chronic disease history, normal BMI level, increased thickness of the gallbladder wall, increased preoperative blood glucose level, leukocytosis, preoperative ERCP history, grade 3 or 4 (Blauer scoring system) adhesions determined during the operation, and multiple stone presence in the bladder were found to be statistically significant risk factors for conversion to open surgery. Conclusions.Patients in the risk group should be informed by experienced laparoscopic surgeons about the potential conversion to open surgery and decision on such conversion should be made when necessary.

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Section: Discussionmentioning

confidence: 82%

Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Ekici¹,

Tatlı²,

Kanlıöz³

2019

Adv Clin Exp Med

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“…[ 3 ] Morbidity is reported to be 5–15% and mortality 0–1% in cholecystectomies performed in the geriatric population. [ 4 ] Elective surgery with acceptable morbidity and mortality is preferred over emergency procedures. [ 5 ] On the other hand, cholecystectomies performed in the elderly population cannot always be performed under elective conditions, but unfortunately, they are also performed under emergency conditions.…”

Section: Introductionmentioning

confidence: 99%

Can neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognostic nutrition index, and albumin be used to predict cholecystectomy morbidity in super-elderly patients?

Kartal

Kalaycı

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: This study aimed to evaluate the usability of neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic nutritional index (PNI), and serum albumin level in predicting cholecystectomy morbidity in elderly patients (85 years and older) who underwent cholecystectomy for acute cholecystitis. METHODS: This retrospective study included super-elderly patients who underwent cholecystectomy due to acute cholecystitis at a tertiary health centre between January 2010 and January 2021. The patients were divided into two groups according to the presence of postoperative complications (morbidity). The differences between the two groups were evaluated. In addition, the role of NLR, PLR, PNI, and serum albumin level in predicting cholecystectomy morbidity for acute cholecystitis in super-elderly patients was assessed via ROC analysis. RESULTS: Of 30 patients who met the study criteria, 22 (73.3%) were female, and the mean age of all patients was 87.43±2.66 years (range 85–94 years). 7 (23.3%) patients had at least one comorbid disease during the preoperative period. The mean value of NLR, PLR, albumin, and PNI were 8.31, 153.76, 3.45, and 48.37, respectively. The morbidity rate of the study was 23.3%. The area under the curve (AUC) for NLR was 0.466 ([95% confidence interval [CI]: 0.259–0.672]; P=0.787), and the AUC for PLR was 0.429 ([95% CI: 0.201–0.656]; P=0.573). These two factors were not suitable for predicting morbidity. The AUC for PNI was 0.780 ([95% CI: 0.568–0.991]; P=0.027), and the AUC for albumin was 0.894 ([95% CI: 0.770–1.000]; P=0.002). At the cut-off value of 3.05 g/dL, the sensitivity and specificity of albumin were 91.3% and 71.4%, respectively, while the sensitivity and specificity of PNI at the 41.70 cut-off value were 82.6% and 71.4%, respectively. CONCLUSION: This study found that PNI and albumin can be used as predictive factors with high sensitivity and specificity for predicting cholecystectomy morbidity for acute cholecystitis in super-elderly patients. However, NLR and PLR had no significance in predicting cholecystectomy morbidity.

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Outcome analysis of laparoscopic cholecystectomy in patients 65 years and older

Cited by 2 publications

References 14 publications

Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Can neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognostic nutrition index, and albumin be used to predict cholecystectomy morbidity in super-elderly patients?

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