Hypoalbuminemia as a risk factor for difficult laparoscopic cholecystectomy
Del Rivero-Molina LD, Melero-Vela A, Rabago-Sanchez ME, Holguin-Estrada EA, Avalos-Trejo OA, Rivas-Trevino A. Hypoalbuminemia as a risk factor for difficult laparoscopic cholecystectomy. Am J Med Surg. 2020 Oct 2(1):17-22.
From the Department of General Surgery at Hospital General 450, Durango, Mexico. Received on October 9, 2020. Accepted on October 14, 2020. Published on October 15, 2020.
Abstract: Cholelithiasis is one of the most common pathologies of the digestive tract, its incidence is affected by factors such as ethnicity and gender among others. Difficult laparoscopic cholecystectomy refers to the surgical removal of the gallbladder when there are some associated conditions of the same organ or its neighboring organs or of the patient, which do not allow an easy, rapid and comfortable dissection of the gallbladder. Hypoalbuminemia is a decrease in the level of intravascular albumin <3.6 g/dL. Potential mechanisms for hypoalbuminemia include decreased liver disease synthesis, protein malnutrition, increased tissue catabolism, protein-losing enteropathy or change in distribution. Material and method. The Laparoscopy Department of General Hospital 450 was consulted, to request a list of the 692 patients who underwent laparoscopic cholecystectomy from 2012 to 2019. Results. The prevalence of hypoalbuminemia in postoperative patients of laparoscopic cholecystectomy in the General Surgery Service from 2012 to 2019 is 12.7%. Hypoalbuminemia is related to an increase in the conversion rate to open surgery Chi2 = 20.68 p-value = 0.000 OR = 8.10 95% CI [6.6 - 9.8]. Discussion. In our study we found an association of hypoalbuminemia with the presentation of difficult laparoscopic cholecystectomy Chi2 = 6.1 p-values = 0.013 OR = 1.76 95% CI [1.1 - 2.7] as well as with the presence of difficult vesicle, intraoperative bleeding, need to administer antibiotic intraoperatively, Penrose drainage placement, longer surgical time and conversion to open cholecystectomy.
Keywords: Hypoalbuminemia, cholecystectomy, cholelithiasis, difficult cholecystectomy.