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Predictive factors in identifying operative risks in cholecystectomies.

M. Kanlioz, U. Ekici

Abstract

PurposeThis study aims to forecast findings showing the difficulty of operation in cholecystectomy through pre-operative examinations and reduce morbidity and mortality with the predictive data obtained.\n\nMaterials and MethodsIn the preoperative period, the followings were measured in patients who will undergo cholecystectomy: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), WBC, Neutrophil ratio (NR), erythrocyte distribution range (RDW), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total bilirubin (TB), direct bilirubin (DB). Following the preoperative ultrasound (USG), the patients were recorded in two groups as patients with \"normal\" and \"increased\" gallbladder wall thickness. Also, the patients were asked if they underwent ERCP and whether they received antibiotic treatment in the last 10 days due to their disease in the preoperative period. The appearance of the peroperative gallbladder was recorded in two groups as \"has a normal appearance\" or \"edematous and/or adherent to peripheral tissues\". Whether or not there is a correlation between the preoperative findings and peroperative appearance was evaluated. The recordings and analyzes were made using SPSS statistics program. Correlation between the data were analyzed by Chi-square test. p<0.05 was considered significant.\n\nResultsThe study achieved statistically significant results for the correlation between the \"gallbladder edema and/or adhesion to peripheral tissues\" in the peroperative period and the following five parameters: increased WBC, increased NR, increased gallbladder wall thickness at USG, compulsory ERCP and receipt of antibiotic treatment for the disease in the last 10 days.(p<0,05).\n\nConclusionTaking into consideration the presence, in the preoperative period, of some or all of the five criteria-namely, increased WBC, increased NR, increased gallbladder wall thickness at USG, receiving antibiotic treatment for the disease in the last 10 days and undergoing ERCP-in patients with cholelithiasis for whom cholecystectomy is envisaged would make it easier to estimate the degree of difficulty of the surgery and the possibility of encountering difficult and complicated cases.

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02 /Specification & Classification

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