Armaghane Danesh Bimonthly Journal (Aug 2020)
Evaluating the Preoperative Laboratory Findings in Predicting the Difficulty of Laparoscopic Cholecystectomy
Abstract
Background & aim: One of the most common complications in acute cholecystitis surgery is to identify the risk factors for converting laparoscopic cholecystectomy to open surgery. As a result, the aim of the present study was to determine and evaluate preoperative laboratory findings in predicting the severity of cholecystectomy. Methods: In this descriptive cross-sectional study, 122 patients who underwent laparoscopic cholecystectomy and laparoscopic surgery in Shahid Beheshti, Nekouei and Forqani hospitals from September 2016 to September 2017 were performed. Prior to surgery, patient information such as age, gender, and laboratory findings such as: WBC, ALT, AST, T Bill were registered in the checklist. Finally, the difficulty of the operation was divided into two easy degrees (less than 60 minutes and without complications) and difficult (above 60 minutes with complications such as bleeding or open surgery) and all the information was entered into SPSS software version 22. And was analyzed using Mann-Whitney test (due to lack of normal data distribution). In this study, a significance level of less than 0.05 was considered. Results: 28 patients(22.4%) were male and 97 patients(77.6%) were female. The mean age of patients was 44.66 ±13.85 years. The number of difficult operations was 35(28%) and easy operations were 90(72%) and conversion to open surgery occurred in 3 cases. There was a significant relationship between preoperative laboratory findings between AST(p= 0.34), T Bill(p= 0.008), WBC(p=0.0001) and operative severity, but between ALT(p=0.065). no significant relationship was found with the difficulty of cholecystectomy. Conclusion: The results indicated that preoperative laboratory findings could provide valuable data in predicting the difficulty of laparoscopic cholecystectomy. Conversely, in a significant number of cases, the matching of preoperative laboratory findings with surgical findings is unsatisfactory. In this group of patients, the difficulty of the operation and the need for open surgery can only be assessed during laparoscopic cholecystectomy.
