Risk factors for postoperative complications of laparoscopic cholecystectomy in acute cholecystitis

Jota Watanabe, MD, Tomoyuki Nagaoka, MD, Yusuke Nishi, MD, Katsuhiro Tomofuji, MD, Yusuke Nakagawa, MD, Naoki Ishida, MD, Yoshinori Imai, MD, Kenji Nezu, MD, Kenzo Okada, MD, Shinsuke Kajiwara, MD. Department of Surgery, Uwajima City Hospital

We analyzed risk factors that induce postoperative complications of laparoscopic cholecystectomy for acute cholecystitis.   Participants comprised 289 acute cholecystitis patients who underwent laparoscopic cholecystectomy including conversion to open surgery from January 2010 to December 2014 in our hospital, and we defined postoperative complications according to Clavien-Dindo classification. Postoperative complications occurred in 24 patients (8.3%). A univariate analysis showed that the risk factors for postoperative complications included a duration from symptoms to surgery longer than 72h, the severity classification greater than mild according to Tokyo guidelines 2013, intraoperative heavy blood loss and an elevated C-reactive protein (CRP) value. The multivariate analysis showed that the risk factors for postoperative complications included intraoperative blood loss >223 g and a CRP value >12.7 mg/dl.  More careful correspondence is demanded about the cases having the risk factors on enforcing laparoscopic cholecystectomy for acute cholecystitis.

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