Routine postoperative blood tests fail to reliably predict procedure-related complications after laparoscopic cholecystectomy
| Autor: | Robert Bachmann, Jens Strohäker, Lisa Wiegand, Alfred Königsrainer, Ruth Ladurner, Christian Beltzer |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Bilirubin 030230 surgery Biliary complications Cohort Studies Laparoscopic cholecystectomy 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Gallstone disease Humans Medicine Common Bile Duct Blood tests Hematologic Tests Common bile duct business.industry Vascular surgery Surgery Cardiac surgery Choledocholithiasis medicine.anatomical_structure Cholecystectomy Laparoscopic chemistry Cardiothoracic surgery 030220 oncology & carcinogenesis Original Article business Perioperative care Abdominal surgery Cohort study |
| Zdroj: | Langenbeck's Archives of Surgery |
| ISSN: | 1435-2451 1435-2443 |
| Popis: | PurposeLaparoscopic cholecystectomy is a highly standardized surgical procedure with a low risk of complications. However, once complications develop, they can be life-threatening. The aim of this study was to evaluate the value of blood tests on postoperative day one regarding their potential to predict postoperative complicationsMethodsA cohort study of 1706 consecutive cholecystectomies performed at a tertiary hospital and teaching facility over a 5-year period between 2014 and 2019.ResultsPatients that had open CCE or conversion CCE were excluded. One thousand five hundred eighty-six patients were included in the final analysis that received a laparoscopic cholecystectomy (CCE). One thousand five hundred twenty-three patients had blood tests on POD 1. Forty-one complications were detected including 14 bile leaks, 2 common bile duct injuries, 13 choledocholithiasis, 9 hematomas, and 2 active bleedings. Bilirubin was elevated in 351 patients on POD 1. A drop of more than 3 mg/dl of hemoglobin was reported in 39 patients. GPT was elevated 3 × above the upper limit in 102 patients. All three tests showed a low sensitivity and specificity in detecting postoperative complications.ConclusionsEarly postoperative blood tests alone show a low specificity in detecting postoperative complications after laparoscopic CCE. Their main benefit appears to be the negative predictive value, when they are normal. Routine blood testing appears to be unnecessary and should be based on the intraoperative diagnosis and postoperative clinical findings. |
| Databáze: | OpenAIRE |
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