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Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis


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タイトル: Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis
著者: Hayama, Satoshi 著作を一覧する
Ohtaka, Kazuto 著作を一覧する
Shoji, Yasuhito 著作を一覧する
Ichimura, Tatsunosuke 著作を一覧する
Fujita, Miri 著作を一覧する
Senmaru, Naoto 著作を一覧する
Hirano, Satoshi 著作を一覧する
キーワード: Acute cholecystitis
Difficult laparoscopic cholecystectomy
Histopathologic necrotizing cholecystitis
Laparoscopic cholecystectomy
Operative timing
発行日: 2016年10月
出版者: Society of Laparoendoscopic Surgeons
誌名: Journal of the society of laparoendoscopic surgeons
巻: 20
号: 4
開始ページ: e2016.00065
出版社 DOI: 10.4293/JSLS.2016.00065
抄録: Background and Objectives: Factors that contribute to difficult laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) that would affect the performance of early surgery remain unclear. The purpose of this study was to identify such risk factors. Methods: One hundred fifty-four patients who underwent LC for AC were retrospectively analyzed. The patients were categorized into early surgery and delayed surgery. Factors predicting difficult LC were analyzed for each group. The operation time, bleeding, and cases of difficult laparoscopic surgery (CDLS)/conversion rate were analyzed as an index of difficulty. Analyses of patients in the early group were especially focused on 3 consecutive histopathological phases: edematous cholecystitis (E), necrotizing cholecystitis (N), suppurative/subacute cholecystitis (S). Results: In the early group, the CDLS/conversion rate was highest in necrotizing cholecystitis. Its rate was significantly higher than that of the other 2 histopathological types (N 27.9% vs E and S 7.4%; P = .037). In the delayed-surgery group, a higher white blood cell (WBC) count and older age showed significant correlations with the CDLS/conversion rate (P = .034 and P = .004). Conclusion: In early surgery, histopathologic necrotizing cholecystitis is a risk factor for difficult LC in AC. A higher WBC count and older age are risk factors for delayed surgery.
資料タイプ: article
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 平野 聡


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