Clinical-Surgical Profile of Patients Undergoing Laparoscopic Cholecystectomy in the Northern Region of Mexico
José Belisario Sánchez Herrera *
Instituto Mexicano del Seguro Social, Hospital General Regional de Especialidades No. 13 “XIV de Septiembre”, Tuxtla Gutiérrez, Chiapas, México.
Francisco Xavier Cabrera Mendoza
Hospital General ISSSTE, Saltillo, Coahuila, México.
Luis Manuel Romero Mora
Hospital General ISSSTE, Saltillo, Coahuila, México.
Erick Santiago Santeliz Bojorquez
Instituto Mexicano del Seguro Social, Hospital General Regional de Especialidades No. 13 “XIV de Septiembre”, Tuxtla Gutiérrez, Chiapas, México.
Brenda Elizabeth Betancourt Rodríguez
Hospital Angeles-Andares, Zapopan, Jalisco, México.
Theresa Esmeralda Churape Cornejo
Hospital Angeles, Tijuana, Baja California, México.
Enrique Josue Cruz Hidalgo
Instituto Mexicano del Seguro Social, Hospital General Regional de Especialidades No. 13 “XIV de Septiembre”, Tuxtla Gutiérrez, Chiapas, México.
Exar Geovani Martinez Laguna
Instituto Mexicano del Seguro Social, Hospital General Regional de Especialidades No. 13 “XIV de Septiembre”, Tuxtla Gutiérrez, Chiapas, México.
Shirley Yoselin Salazar Ruiz
Instituto Mexicano del Seguro Social, Hospital General Regional de Especialidades No. 13 “XIV de Septiembre”, Tuxtla Gutiérrez, Chiapas, México.
Eliezer Andrés Álvarez Aguilar
Instituto Mexicano del Seguro Social, Hospital General Regional de Especialidades No. 13 “XIV de Septiembre”, Tuxtla Gutiérrez, Chiapas, México.
Silvia Pacheco Gómez
Hospital General ISSSTE, Saltillo, Coahuila, México.
*Author to whom correspondence should be addressed.
Abstract
Background: Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures worldwide. However, clinical and surgical factors can create technically challenging conditions for its execution, resulting in morbidity, mortality, and excessive use of resources.
Aim: To know the implications of clinical and surgical profile of patients undergoing laparoscopic cholecystectomy in the Northern Region of Mexico.
Methods: This retrospective and descriptive study included patients enrolled in the general surgery service who underwent laparoscopic cholecystectomy between January and April 2022 at a secondary-level public hospital in the Northern Region of Mexico. All medical records of patients of both sexes and over 18 years of age were included. Those in which serious complications were recorded during the procedure were excluded. Those in whom serious complications were recorded during the procedure were excluded, mainly because they were referred to tertiary medical units. To collect demographic, clinical, hematological, biochemical, surgical and radiological data. Descriptive statistics were applied using the Statistical Package for the Social Sciences (SPSS) version 25.
Results: We reviewed 313 medical records. 75.4 % were women. The mean age was 53.7 ± 15.2 years. 56.5 % were overweight. 41.9 % underwent emergency surgery. 26.2 % recorded technically difficult laparoscopic cholecystectomy. The most frequent findings among patients were: abnormalities in liver function (> 47.0 %) and lipid profile (> 35.0 %); jaundice (42.2 %); leukocytosis (55.3 %); hyperbilirubinemia (49.5 %); gallstones larger than 10 mm (48.6 %); gallbladder wall thickness ≥ 4 mm (58.1 %); and hypervascularity on Doppler ultrasound (58.8 %). Seven (2.2 %) patients presented with obstructive jaundice and underwent endoscopic retrograde cholangiopancreatography.
Conclusion: The results show that demographic and epidemiological conditions in the Region Northern Mexico increase the risk of acute cholelithiasis. Therefore, it is important to understand the clinical and surgical risk factors in patients undergoing laparoscopic cholecystectomy to identify conditions that may complicate the procedure, resulting in morbidity and higher hospital costs.
Keywords: Biochemical markers, cholelithiasis, clinical picture or findings, radiological markers