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World Journal of Surgery

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01-10-2018 | Original Scientific Report

Impact of Jaundice on Outcomes Following Emergency Laparoscopic Cholecystectomy in Patients with Choledocholithiasis

Authors: Benjamin R. Poh, Paul A. Cashin, Daniel G. Croagh

Published in: World Journal of Surgery | Issue 10/2018

Abstract

Introduction

Traditional teaching dictates that it may not be prudent to take the jaundiced patient to theatre for emergency laparoscopic cholecystectomy as they may experience worse outcomes following surgery.

Methods

A prospective cohort of 104 patients undergoing emergency laparoscopic cholecystectomy was stratified into two groups using a serum total bilirubin of above 50 μmol/L (2.9 mg/dL) to define the jaundiced group. Primary outcomes were morbidity and mortality rate. The Clavien–Dindo classification and the novel Comprehensive Complication Index (CCI) were applied to the grading of surgical complications. Multivariate analysis to identify possible predictors of morbidity and length of stay was also performed.

Results

Overall morbidity rate in the jaundiced group was 28 versus 36% (control), p = 0.405. Mean CCI in the jaundiced group was 5.28 versus 8.00 in the control group, p = 0.229. Mean length of stay was shorter in the jaundiced group, 4.65 versus 6.51 days, p = 0.036. There were no peri-operative mortalities or conversions to open surgery. Only male gender and the presence of retained stones were found to be associated with morbidity. Serum total bilirubin was not associated with increased morbidity.

Conclusion

Amongst patients undergoing laparoscopic cholecystectomy who are found to have choledocholithiasis on IOC, the presence of jaundice does not appear to contribute towards increased morbidity.

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Title: Impact of Jaundice on Outcomes Following Emergency Laparoscopic Cholecystectomy in Patients with Choledocholithiasis
Authors: Benjamin R. Poh
Paul A. Cashin
Daniel G. Croagh
Publication date: 01-10-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 10/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4588-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Impact of Jaundice on Outcomes Following Emergency Laparoscopic Cholecystectomy in Patients with Choledocholithiasis

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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