World Journal of Surgery最新文献_第2页

Comparing gastrointestinal stromal tumor outcomes between geriatric and non-geriatric patients: A population-based analysis. 比较老年患者和非老年患者的胃肠道间质瘤预后：基于人群的分析。

World Journal of Surgery Pub Date : 2024-04-22 DOI: 10.1002/wjs.12170

Abhiram Singh, B. Chitti, Christopher Aguiar, A. Wernicke, Craig E. Devoe, Husneara Rahman, Cristina Sison, B. Parashar

{"title":"Comparing gastrointestinal stromal tumor outcomes between geriatric and non-geriatric patients: A population-based analysis.","authors":"Abhiram Singh, B. Chitti, Christopher Aguiar, A. Wernicke, Craig E. Devoe, Husneara Rahman, Cristina Sison, B. Parashar","doi":"10.1002/wjs.12170","DOIUrl":"https://doi.org/10.1002/wjs.12170","url":null,"abstract":"BACKGROUND\u0000Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the GI tract. SEER is an extensive cancer database which proves useful in analyzing population trends. This analysis investigated GIST outcomes between geriatric & non-geriatric patients.\u0000\u0000\u0000METHODS\u0000SEER*STAT 8.4.0.1 was used to extract relevant GIST data from 2000 to 2019. Geriatric age was defined as ≥70 years. Variables included age, sex, surgery, cancer-specific death, and overall survival. Statistical tests included univariate analysis using KM survival estimate (95% confidence interval) to calculate 5-year survival (5YS). Log-Rank tests determined statistical significance. Multivariable Cox's PH regression estimated the geriatric hazard death ratio adjusted for sex, stage, and surgery.\u0000\u0000\u0000RESULTS\u0000The number of patients included was 13,579, yielding overall 5YS of 68.6% (95% CI 67.7-69.5). Cancer-specific death was 39.11% in 2000 & 3.33% in 2019. Non-geriatric & geriatric patient data yielded 5YS of 77.4% (76.4%-78.3%) and 53.3% (51.7%-54.8%) respectively (p < 0.0001). For no surgery/surgery, younger patient data yielded 5YS of 48.7% (45.8%-51.4%) and 83.7% (82.7%-84.7%) respectively (p < 0.0001); geriatric data yielded 5YS of 29.3% (26.5%-32.1%) and 62.8% (60.8%-64.6%) respectively (p < 0.0001). Multivariable analysis yielded a geriatric hazard death of 2.56 (2.42-2.70) (p < 0.0001).\u0000\u0000\u0000CONCLUSIONS\u0000Cancer-specific death decreased since 2000, indicating an improvement in survival & treatment methods. Observed lower survival rates overall in the geriatric group. Surgery appeared to enhance survival rates in both groups, suggesting that surgery is an important factor in GIST survival regardless of age. Large prospective studies will help define clinical management for geriatric patients.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Restoration of intestinal continuity following emergency sigmoid colectomy for sigmoid volvulus: An American College of Surgeons National Surgical Quality Improvement Program analysis using coarsened exact matching. 紧急乙状结肠切除术治疗乙状结肠肿后肠道连续性的恢复：美国外科学院国家外科质量改进计划使用粗化精确匹配进行的分析。

World Journal of Surgery Pub Date : 2024-04-21 DOI: 10.1002/wjs.12188

S. Atamanalp, Cansu Tatar Atamanalp

引用次数: 0

The trauma laparotomy-A key procedure that lacks global data. 创伤开腹手术--缺乏全球数据的关键手术。

World Journal of Surgery Pub Date : 2024-04-17 DOI: 10.1002/wjs.12168

M. F. Bath, Tom Bashford

引用次数: 0

Postoperative pancreatic fistula after pancreaticogastrostomy versus pancreatojejunostomy after pancreatic resection, a comparative systematic review and meta-analysis. 胰腺切除术后胰胃造口术与胰空肠造口术术后胰瘘的比较系统综述和荟萃分析。

World Journal of Surgery Pub Date : 2024-04-17 DOI: 10.1002/wjs.12173

M. Salman, A. Elewa, Mohammed Elsherbiny, Mohamed Tourkey, Evelyn Nkem Emechap, Stewart Chikukuza, A. Salman

{"title":"Postoperative pancreatic fistula after pancreaticogastrostomy versus pancreatojejunostomy after pancreatic resection, a comparative systematic review and meta-analysis.","authors":"M. Salman, A. Elewa, Mohammed Elsherbiny, Mohamed Tourkey, Evelyn Nkem Emechap, Stewart Chikukuza, A. Salman","doi":"10.1002/wjs.12173","DOIUrl":"https://doi.org/10.1002/wjs.12173","url":null,"abstract":"BACKGROUND\u0000In patients undergoing pancreaticoduodenectomy (PD), there has been some evidence favoring pancreaticogastrostomy (PG) over pancreatojejunostomy (PJ) in the occurrence of postoperative pancreatic fistulas (POPF) and considering PG as a safer anastomotic technique. However, other publications revealed comparable incidences of POPF attributed to both techniques. The current work attempts to reach a more consolidated conclusion about such an issue.\u0000\u0000\u0000METHODS\u0000This is a systematic review and meta-analysis that analyzed the studies comparing PG and PJ during PD in terms of the rate of POPF occurrence. Studies were obtained by searching the Scopus, PubMed Central, and Cochrane Central Register of Controlled Trials databases.\u0000\u0000\u0000RESULTS\u000035 articles published between 1995 and 2022 presented data from 14,666 patients; 4547 underwent PG and 10,119 underwent PJ. Statistically significant lower rates of POPF (p = 0.044) and clinically relevant CR-POPF (p = 0.043) were shown in the PG group. The post-pancreatectomy hemorrhage (PPH) was significantly higher in the PG group, while no significant difference was found between the two groups in the clinically significant PPH. No statistically significant differences were found regarding the amount of intraoperative blood loss, length of hospital stay, DGE, overall morbidity rates, reoperation rates, or mortality rates. The percentage of male sex in the PG group and the percentage of soft pancreas in the PJ group seem to influence the odds ratio of CR-POPF (p = 0.076 and 0.074, respectively).\u0000\u0000\u0000CONCLUSION\u0000The present study emphasizes the superiority of PG over PJ regarding CR-POPF rates. Higher rates of postoperative hemorrhage were associated with PG. Yet, the clinically significant hemorrhage rate was comparable between the two groups.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"16 S1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of life following repair of large hiatal hernia is not influenced by the use of mesh-Longer-term follow-up from a randomized trial. 大食道裂孔疝修补术后的生活质量不受网片使用的影响--一项随机试验的长期随访。

World Journal of Surgery Pub Date : 2024-04-17 DOI: 10.1002/wjs.12185

Mathew A Amprayil, T. Irvine, Sarah K. Thompson, T. Bright, Ahmad Aly, P. Devitt, Glyn G. Jamieson, David I. Watson

{"title":"Quality of life following repair of large hiatal hernia is not influenced by the use of mesh-Longer-term follow-up from a randomized trial.","authors":"Mathew A Amprayil, T. Irvine, Sarah K. Thompson, T. Bright, Ahmad Aly, P. Devitt, Glyn G. Jamieson, David I. Watson","doi":"10.1002/wjs.12185","DOIUrl":"https://doi.org/10.1002/wjs.12185","url":null,"abstract":"INTRODUCTION\u0000The use of prosthetic mesh in laparoscopic repair of large hiatus hernias remains controversial. Clinical and quality of life outcomes from a randomized controlled trial of mesh versus suture repair previously showed few differences at early follow-up. This study evaluated longer-term quality of life outcomes from that trial.\u0000\u0000\u0000METHODS\u0000A prospective, multicentre, double blind randomized controlled trial assessed three methods of repair for large hiatus hernias: sutures-only versus absorbable mesh versus non-absorbable mesh. Quality of life was assessed using the Short-Form 36 (SF-36) questionnaire which was completed preoperatively and then at 3, 6, 12 months following surgery and annually thereafter. SF-36 outcomes were compared across the three repair techniques at longer-term follow-up (3-6 years), and to earlier baseline and 12-month outcomes.\u0000\u0000\u0000RESULTS\u0000126 patients were randomized; 43-suture-only, 41-absorbable mesh and 42-non-absorbable mesh. Questionnaires were completed by 118 patients preoperatively, 115 at 12 months and 98 at longer-term follow-up (median 5 years). There were no significant differences between the repair techniques for the subscale and composite scores at longer-term follow-up. The mental component score improved significantly after surgery and was sustained across follow-up for all techniques. The physical component score also improved significantly but was lower at longer-term follow-up compared to the 12-month follow up in both mesh groups.\u0000\u0000\u0000CONCLUSION\u0000Surgical repair of large hiatus hernias provides sustained long-term improvement in quality of life. The addition of mesh does not improve quality of life.\u0000\u0000\u0000TRIAL REGISTRATION\u0000This trial is registered with the Australia and New Zealand Clinical Trials Registry ACTRN12605000725662.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":" 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140692604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Upper gastrointestinal and hepatopancreaticobiliary surgery in New Zealand: Balancing the volume-outcome relationship with accessibility in a surgically low volume country. 新西兰的上消化道和肝胆胰外科手术：在一个手术量较少的国家平衡手术量与手术结果之间的关系。

World Journal of Surgery Pub Date : 2024-04-12 DOI: 10.1002/wjs.12174

Jonathan Koea, Phillip Chao, S. Srinivasa, Jason Gurney

{"title":"Upper gastrointestinal and hepatopancreaticobiliary surgery in New Zealand: Balancing the volume-outcome relationship with accessibility in a surgically low volume country.","authors":"Jonathan Koea, Phillip Chao, S. Srinivasa, Jason Gurney","doi":"10.1002/wjs.12174","DOIUrl":"https://doi.org/10.1002/wjs.12174","url":null,"abstract":"INTRODUCTION\u0000New Zealand has a population of only 5.5 million meaning that for many surgical procedures the country qualifies as a \"low-volume center.\" However, the health system is well developed and required to provide complex surgical procedures that benchmark internationally against comparable countries. This investigation was undertaken to review regional variation and volumes of complex resection and palliative upper gastrointestinal (UGI) surgical procedures within New Zealand.\u0000\u0000\u0000METHODS\u0000Data pertaining to patients undergoing complex resectional UGI procedures (esophagectomy, gastrectomy, pancreatectomy, and hepatectomies) and palliative UGI procedures (esophageal stenting, enteroenterostomy, biliary enteric anastomosis, and liver ablation) in a New Zealand hospital between January 1, 2000 and December 31, 2019 were obtained from the National Minimum Dataset.\u0000\u0000\u0000RESULTS\u0000New Zealand is a low-volume center for UGI surgery (229 hepatectomies, 250 gastrectomies, 126 pancreatectomies, and 74 esophagectomies annually). Over 80% of patients undergoing hepatic resection/ablation, gastrectomy, esophagectomy, and pancreatectomy are treated in one of the six national cancer centers (Auckland, Waikato, Mid-Central, Capital Coast, Canterbury, or Southern). There is evidence of the decreasing frequency of these procedures in small centers with increasing frequency in large centers suggesting that some regionalization is occurring. Palliative procedures were more widely performed. Indigenous Māori were less likely to be treated in a nationally designated cancer center than non-Māori.\u0000\u0000\u0000CONCLUSIONS\u0000The challenge for New Zealand and similarly sized countries is to develop and implement a system that optimizes the skills and pathways that come from a frequent performance of complex surgery while maintaining system resilience and ensuring equitable access for all patients.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140712516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pregnancy and infertility in orthopedics: A review of the current state. 骨科中的妊娠与不孕：现状回顾。

World Journal of Surgery Pub Date : 2024-04-10 DOI: 10.1002/wjs.12179

Nazanin Kermanshahi, Hayden Hartman, Elizabeth Matzkin, Arianna L. Gianakos

{"title":"Pregnancy and infertility in orthopedics: A review of the current state.","authors":"Nazanin Kermanshahi, Hayden Hartman, Elizabeth Matzkin, Arianna L. Gianakos","doi":"10.1002/wjs.12179","DOIUrl":"https://doi.org/10.1002/wjs.12179","url":null,"abstract":"BACKGROUND\u0000Orthopedic surgery continues to have one of the lowest rates of female trainees among all medical specialties in the United States. Barriers to pursuing a surgical residency include the challenges of family planning and work-life balance during training.\u0000\u0000\u0000METHODS\u0000A systematic literature search of articles published between June 2012 and December 2022 in the MEDLINE, EMBASE, and Cochrane databases was performed in January 2023 according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). Studies were included if they evaluated pregnancy and peripartum experience and/or outcomes amongst orthopedic surgeons or trainees.\u0000\u0000\u0000RESULTS\u0000Eighteen studies were included. Up to 67.3% of female orthopedic surgeons and trainees and 38.7% of their male counterparts delayed childbearing during residency. The most reported reasons for this delay included career choice as an orthopedic surgeon, residency training, and reputational concerns among faculty or co-residents. Infertility ranged from 17.0% to 30.4% in female orthopedic surgeons and up to 31.2% suffered obstetric complications. Assisted Reproductive Technology (ART) resulted in 12.4%-56.3% of successful pregnancies. Maternity and paternity leaves ranged from 1 to 11 weeks for trainees with more negative attitudes associated with maternal leave.\u0000\u0000\u0000CONCLUSIONS\u0000Female orthopedic trainees and attending delay childbearing, experience higher rates of obstetric complications, and more stigma associated with pregnancy compared to their male colleagues. Program and institutional policies regarding maternity and paternity leave are variable across programs, and therefore, attention should be directed toward standardizing policies.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"51 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140720309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early safety outcomes of laparoscopic one anastomosis gastric bypass in patients with class III, IV, and V obesity. III、IV 和 V 级肥胖症患者腹腔镜单吻合胃旁路术的早期安全性结果。

World Journal of Surgery Pub Date : 2024-04-09 DOI: 10.1002/wjs.12182

N. Sakran, A. Raziel, Keren Hod, Bella Azaria, U. Kaplan

{"title":"Early safety outcomes of laparoscopic one anastomosis gastric bypass in patients with class III, IV, and V obesity.","authors":"N. Sakran, A. Raziel, Keren Hod, Bella Azaria, U. Kaplan","doi":"10.1002/wjs.12182","DOIUrl":"https://doi.org/10.1002/wjs.12182","url":null,"abstract":"BACKGROUND\u0000The extremely obese patient deserves special consideration: significant comorbidities, technical difficulties, and increased postoperative morbidity and mortality are all expected in this patient population. The study compared early postoperative complications (≤30-day) following one-anastomosis gastric bypass (OAGB) morbidity in patients with morbid obesity class IV obesity, body mass index (BMI) ≥50-59.9 kg/m2, and class V obesity, BMI ≥60 patients.\u0000\u0000\u0000METHODS\u0000We retrospectively reviewed perioperative OAGB outcomes in three BMI groups. Operative time, length of stay (LOS), and overall early postoperative complication rates were studied. Patient-reported complications were ranked by Clavien-Dindo Classification (CDC).\u0000\u0000\u0000RESULTS\u0000Between January 2017-December 2021, consecutive patients with obesity class III (n = 2950), IV (n = 256), and V (n = 23) underwent OAGB. BMI groups were comparable in sex, age, and associated comorbidities. Mean operative time was significantly longer in the higher BMI groups: class III (66.5 ± 25.6 min), IV (70.5 ± 28.7 min), and V (80.0 ± 34.7 min), respectively (p = 0.018); no difference in LOS. In respective BMI classes, ≤30-day complication rates were 3.2%, 3.5%, and 4.3% (p = 0.926). The respective number of patients with CDC grades of one to two were 45 (1.5%), 6 (2.3%), and 1 (4.3%), p = 0.500; and in grade ≥3a, 25 (0.8%), 1 (0.4%), 0 (0.0%), p = 0.669. There was 0.06% mortality (n = 2 in 3229), both in BMI class III.\u0000\u0000\u0000CONCLUSIONS\u0000OAGB is a safe BS procedure in patients with class III, IV, and V obesity in the perioperative term with comparable ≤30-day morbidity in the three BMI groups.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"34 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140720850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Late video-assisted thoracoscopic surgery versus thoracostomy tube reinsertion for retained hemothorax after penetrating trauma, a prospective randomized control study. 前瞻性随机对照研究：穿透性创伤后血气胸潴留的晚期视频辅助胸腔镜手术与重新插入胸腔造口管的对比。

World Journal of Surgery Pub Date : 2024-04-08 DOI: 10.1002/wjs.12181

S. Edu, Andrew Nicol, Valentin Neuhaus, D. McPherson, P. Navsaria

{"title":"Late video-assisted thoracoscopic surgery versus thoracostomy tube reinsertion for retained hemothorax after penetrating trauma, a prospective randomized control study.","authors":"S. Edu, Andrew Nicol, Valentin Neuhaus, D. McPherson, P. Navsaria","doi":"10.1002/wjs.12181","DOIUrl":"https://doi.org/10.1002/wjs.12181","url":null,"abstract":"BACKGROUND\u0000Early video-assisted thoracoscopic surgery (VATS) is the recommended treatment of choice for retained hemothorax (RH). A prospective single-center randomized control study was conducted to compare outcomes between VATS and thoracostomy tube (TT) reinsertion for patients with RH after penetrating trauma in a resource constrained unit. Our hypothesis was that patients with a RH receiving VATS instead of TT reinsertion would have a shorter hospital stay and lesser complications.\u0000\u0000\u0000MATERIALS AND METHODS\u0000From January 2014 to November 2019, stable patients with thoracic penetrating trauma complicated with retained hemothoraces were randomized to either VATS or TT reinsertion. The outcomes were length of hospital stay (LOS) and complications.\u0000\u0000\u0000RESULTS\u0000Out of the 77 patients assessed for eligibility, 65 patients were randomized and 62 analyzed: 30 in the VATS arm and 32 in the TT reinsertion arm. Demographics and mechanisms of injury were comparable between the two arms. Length of hospital stay was: preprocedure: VATS 6.8 (+/-2.8) days and TT 6.6 (+/- 2.4) days (p = 0.932) and postprocedure: VATS 5.1 (+/-2.3) days, TT 7.1 (+/-6.3) days (p = 0.459), total LOS VATS 12 (+/- 3.9) days, and TT 14.4 (+/-7) days (p = 0.224). The TT arm had 15 complications compared to the VATS arm of four (p = 0.004). There were two additional procedures in the VATS arm and 10 in the TT arm (p = 0.014).\u0000\u0000\u0000CONCLUSION\u0000VATS proved to be the better treatment modality for RH with fewer complications and less need of additional procedures, while the LOS between the two groups was not statistically different.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"12 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laparoscopic subtotal cholecystectomy outcomes across a low-and middle-income country metropolitan health service. 中低收入国家大都市医疗服务机构的腹腔镜胆囊次全切除术效果。

World Journal of Surgery Pub Date : 2024-04-06 DOI: 10.1002/wjs.12180

K. Booyse, J. Lindemann, Mariska Calitz, M. Bernon, Eduard Jonas, C. Kloppers

{"title":"Laparoscopic subtotal cholecystectomy outcomes across a low-and middle-income country metropolitan health service.","authors":"K. Booyse, J. Lindemann, Mariska Calitz, M. Bernon, Eduard Jonas, C. Kloppers","doi":"10.1002/wjs.12180","DOIUrl":"https://doi.org/10.1002/wjs.12180","url":null,"abstract":"BACKGROUND\u0000Laparoscopic subtotal cholecystectomy (LSC) is a safe alternative for difficult cholecystectomies to prevent bile duct injury and open conversion. The primary aim was to detail the use and outcomes on LSCs.\u0000\u0000\u0000METHODS\u0000Retrospective analysis of a prospectively maintained database of laparoscopic cholecystectomy (LC). Relative clinical factors, outcomes, and 30-day follow-up between LSC and LC were compared using univariate and multivariate analyses.\u0000\u0000\u0000RESULTS\u0000Six hundred and twenty four cholecystectomies were performed and 53 (8.5%) required LSC. 81.8% were fenestrating LSC. Male sex was significantly overrepresented in the LSC group (p < 0.01) and patients requiring LSC were significantly older (p < 0.01). Same admission cholecystectomy was associated with a higher risk of LSC (p < 0.01). Patients with a history of previous surgery, preoperative ERCP, or percutaneous cholecystostomy had an increased risk of undergoing LSC (p < 0.01). A necrotic gallbladder was the most significant predictor of the need for a LSC (p < 0.001). A contracted gallbladder, extensive adhesions, gallbladder empyema, and severe inflammation were significant predictors of difficulty (all p < 0.01). Postoperative complications occurred in 26.4% of LSC patients. There were ten (18.9%) Clavien-Dindo Grade III complications, 5.7% required ERCPs, and 9.4% required relook laparotomies. Significantly, more patients in the LSC group developed bile leaks (n = 8, 15%) (p < 0.001). There were two readmissions within 30 days, one mortality, and no BDIs occurred in the LSC cohort.\u0000\u0000\u0000CONCLUSION\u0000LSC provides a feasible surgical option that should be utilized in complex cholecystitis.","PeriodicalId":507313,"journal":{"name":"World Journal of Surgery","volume":"40 137","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0