Prevalencia de colecistectomía laparoscópica difícil y factores asociados en el Hospital José Carrasco Arteaga Cuenca 2017

Abstract

Introduction: laparoscopic cholecystectomy is currently the treatment of choice for biliary pathology, such as cholecystolithiasis and acute cholecystitis, both in elective and emergency surgery; This procedure is not exempt from complications, due to technical difficulties that may hinder the performance of this surgical procedure. Objective: to determine the prevalence of difficult laparoscopic cholecystectomy and associated factors, in the "Hospital José Carrasco Arteaga", during the year 2017. Materials and methods: cross-sectional analytical study, including patients undergoing laparoscopic cholecystectomy. With infinite universe, 95% confidence level, a total sample of 369 patients was obtained. Analysis of the statistical variables (age, gender, obesity, antecedent of abdominal surgery, degree of acute cholecystitis, cholecystolithiasis, antecedent of endoscopic retrograde cholangiopancreatography, acute biliary pancreatitis) was performed in the SPSS version 23 and EPIDAT 3.1 program. RP (95% CI) and chi square (p <0.05) were used for statistical significance. Results: the prevalence of difficult laparoscopic cholecystectomy was 8.7%. The associated factors were: advanced age (RP 3.85, IC95% 1.85-8.02, p 0.00), male gender (RP 2.39, IC95% 1.22-4.69, p 0.00), antecedent of abdominal surgery (RP 2.18, IC95% 1.04 -4.57, p 0.04) mild acute cholecystitis (RP 2.18, 95% CI 1.04-4.57, p 0.04), moderate acute cholecystitis (RP 6.58, 95% CI 3.56-12.1, p 0.00), severe acute cholecystitis ( RP 11.2, IC95% 6.73-18.7, p 0.00). Conclusions: difficult laparoscopic cholecystectomy is significantly related to all grades of acute cholecystitis, history of abdominal surgery, male gender and advanced age.