Factors leading to post-cholecystectomy bleeding requiring reoperation: A case series.

IF 1.1 4区 医学 Q3 SURGERY
Mena Louis, Nathaniel Grabill, Baraa Mohamed, Emily Murdoch, Morgan A Krause, Bradley Kuhn
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引用次数: 0

Abstract

Introduction: Laparoscopic cholecystectomy is widely regarded as the standard treatment for symptomatic gall bladder diseases due to its minimally invasive nature and favorable recovery profile. However, hemorrhagic complications pose significant risks to patient safety and outcomes.

Patients and methods: This retrospective case series aimed to evaluate the incidence, risk factors and outcomes associated with intraoperative and post-operative hemorrhagic complications in patients undergoing cholecystectomy. Eighteen patients who experienced significant bleeding necessitating unplanned reoperations were included in the analysis. Data were collected encompassing demographic information, comorbidities, surgical details and post-operative outcomes.

Results: The study found that older age and higher body mass index (BMI) were strongly correlated with increased estimated blood loss, with each additional year of age increasing the odds of severe hemorrhage by 7% and each unit increase in BMI raising the odds by 15%. Patients with the American Society of Anesthesiologists classifications of 3-4 were 3.5 times more likely to experience severe bleeding. In addition, the use of anticoagulant or antiplatelet therapy was associated with a nearly six-fold increase in the risk of significant hemorrhage. The presence of adhesions or severe inflammation further doubled the risk of substantial blood loss. Hemorrhagic complications were associated with prolonged hospital stays, higher rates of blood transfusions and increased mortality.

Conclusion: These findings highlight the importance of pre-operative risk assessment and tailored surgical strategies to mitigate bleeding risks. Enhancing patient evaluation and optimizing surgical techniques are crucial for improving outcomes and ensuring patient safety in cholecystectomy procedures.

导致胆囊切除术后出血需要再次手术的因素:一个病例系列。
腹腔镜胆囊切除术因其微创性和良好的恢复特点而被广泛认为是有症状的胆囊疾病的标准治疗方法。然而,出血性并发症对患者安全和预后构成重大风险。患者和方法:本回顾性病例系列旨在评估胆囊切除术患者术中和术后出血并发症的发生率、危险因素和结局。我们分析了18例因大出血而不得不进行非计划再手术的患者。收集的数据包括人口统计信息、合并症、手术细节和术后结果。结果:研究发现,年龄越大和身体质量指数(BMI)越高与估计失血量的增加密切相关,年龄每增加一岁,严重出血的几率就增加7%,BMI每增加一个单位,出血的几率就增加15%。美国麻醉学会分类为3-4级的患者出现严重出血的可能性高出3.5倍。此外,使用抗凝或抗血小板治疗与显著出血风险增加近6倍相关。粘连或严重炎症的存在进一步增加了大量失血的风险。出血性并发症与住院时间延长、输血率升高和死亡率增加有关。结论:这些发现强调了术前风险评估和量身定制的手术策略对于降低出血风险的重要性。加强患者评估和优化手术技术对于改善胆囊切除术的结果和确保患者安全至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
0.00%
发文量
151
审稿时长
36 weeks
期刊介绍: Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.
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