Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis

Hayama, Satoshi; Ohtaka, Kazuto; Shoji, Yasuhito et al.

Journal of the society of laparoendoscopic surgeons, 2016, 20(4), e2016.00065

Permalink : https://hdl.handle.net/2115/64306

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アクセス権
open access
URI
https://hdl.handle.net/2115/64306
タイトル
Risk Factors for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis
著者
Hayama, Satoshi ; Ohtaka, Kazuto ; Shoji, Yasuhito ; Ichimura, Tatsunosuke ; Fujita, Miri ; Senmaru, Naoto ; Hirano, Satoshi
著者名
Hayama, Satoshi
著者名
Ohtaka, Kazuto
著者名
Shoji, Yasuhito
著者名
Ichimura, Tatsunosuke
著者名
Fujita, Miri
著者名
Senmaru, Naoto
e-Rad_Researcher
50322813
著者名
Hirano, Satoshi
言語
英語
キーワード
Acute cholecystitis
Difficult laparoscopic cholecystectomy
Histopathologic necrotizing cholecystitis
Laparoscopic cholecystectomy
Operative timing
発行日
2016-10
出版者
Society of Laparoendoscopic Surgeons
収録物名
Journal of the society of laparoendoscopic surgeons
巻(号)
20(4)
ページ
e2016.00065
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.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
権利情報
Creative Commons Attribution-NonCommercial-NoDerivs 3.0 United States
PISSN
1086-8089
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.4293/JSLS.2016.00065