Kolesistektomide morbiditesi olan ve olmayan gruplar arasındaki farklar

Year 2021, Volume: 46 Issue: 3, 1077 - 1085, 30.09.2021

Tolga Kalaycı

Abstract

Amaç: Bu çalışmada Kolesistektomi olgularında postoperatif komplikasyon gelişen hastalar ile postoperatif komplikasyon gelişmeyen hastalar arasındaki farkları belirlemek ve komplikasyonlar açısından dikkat edilmesi gereken parametreleri tanımlanması amaçlanmıştır.
Gereç ve Yöntem: Ocak 2019-Temmuz 2020 tarihleri arasında Iğdır Devlet Hastanesi'nde kolesistektomi yapılan hastalar retrospektif olarak belirlendi. Hastaların genel özellikleri tıbbi kayıtlarından alındı. Ameliyat sonrası 30 gün içinde komplikasyon gelişen hastalar morbidite pozitif grup, komplikasyon gelişmeyen hastalar morbidite negatif grup olarak kabul edildi. İki grup arasındaki farklar değerlendirildi.
Bulgular: Çalışmaya 108 hasta dahil edildi. Hastaların yaş ortalaması 46.44 (dağılım: 18-83) ve 85'i (%78.7) kadındı. Erkek cinsiyet, 40 yaş üstü, ameliyat öncesi ateş ile ultrasonografide (USG) hemanjiyom varlığı ve ipek ile kistik kanal kapatma artan morbidite ile ilişkiliydi. İlginç bir şekilde, aynı ameliyatta göbek fıtığı onarımı azalmış morbidite ile ilişkilendirildi.
Sonuç: Bu çalışma kolesistektomi hastalarında erkek cinsiyet, ileri yaş ve ameliyat öncesi ateş artmış morbidite ile ilişkili olduğunu bulmuştur. Preoperatif hemanjiyom varlığı artmış morbidite ile ilişkili yeni bir parametredir. Ayrıca kolesistektomi sırasında sistik kanal kapatılırken ipek sütür kullanılmamasını ve varsa göbek fıtığı tamir edilmesini öneriyoruz.

Keywords

İleri yaş, Kolesistektomi, Ateş, Hemanjiom, Morbidite, İpek sütür, Göbek Fıtığı tamiri

Differences between groups with and without morbidity in cholecystectomy

Abstract

Purpose: The aim of this study was to determine the differences between the patients with postoperative complications and the patients without postoperative complications in cholecystectomy cases and to identify parameters that should be considered regarding complications.
Materials and Methods: Patients who underwent cholecystectomy between January 2019 and July 2020 at Igdir State Hospital, Igdir, Turkey were identified retrospectively. The patients’ general characteristics were retrieved from their medical records. Patients who developed complications in the 30 days after surgery were considered the morbidity-positive group, and the patients without complications were considered the morbidity-negative group. The differences between the two groups were evaluated.
Results: The study included 108 patients. The patients’ mean age was 46.44 years (range: 18‒83), and 85 (78.7%) were women. Male gender, age over 40 years, preoperative fever with the presence of haemangioma on ultrasonography (USG) and cystic canal closure using silk were associated with increased morbidity. Interestingly, umbilical hernia repair in the same surgery was associated with reduced morbidity.
Conclusion: This study found that male gender, older age, and preoperative fever were associated with increased morbidity in cholecystectomy patients. Presence of preoperative haemangioma is a new parameter associated with increased morbidity. In addition, we recommend using silk sutures when closing the cystic duct during cholecystectomy and repairing the umbilical hernia, if present.

Keywords

Advanced age, Cholecystectomy, Fever, Haemangioma, Morbidity, Silk suture, Umbilical hernia repair

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