Journals / Laparoscopic Endoscopic Surgical Science / 2022 / Cilt: 29 - Sayı: 2

Epigastric port site complications and affecting factors used for gallbladder specimen extraction in laparoscopic cholecystectomy

Pages
65–74
Publication Date
2022-09-04
DOI
—
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⚡ TL;DR(Too Long; Didn't Read)

It was found out that trocar site hematoma was a risk factor causing a 39.37-fold increase in the development of EPSI (<0.001) (95% confidence interval =10.69–144.97), while dilatation at the trocar site was a risk factor causing a 3.1-fold increase (p=0.027) (95% confidence interval =1.14–8.48).

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: Complications occur at the port site where the specimen is excised after laparoscopic cholecystectomy (LC).
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Key Findings & Data:Materials and Methods: The results of patients who underwent LC surgery in our center between January 01, 2018, and December 31, 2020, were retrospectively analyzed.
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Conclusion & Impact:It was found out that trocar site hematoma was a risk factor causing a 39.37-fold increase in the development of EPSI (<0.001) (95% confidence interval =10.69–144.97), while dilatation at the trocar site was a risk factor causing a 3.1-fold increase (p=0.027) (95% confidence interval =1.14–8.48).
🔬Design:Research Article
📍Scope:2018 Verileri
⚙️Variables:Domain Parameters

Abstract

Introduction: Complications occur at the port site where the specimen is excised after laparoscopic cholecystectomy (LC). In this study, it was aimed to investigate port-site complications. Materials and Methods: The results of patients who underwent LC surgery in our center between January 01, 2018, and December 31, 2020, were retrospectively analyzed. Patients who were decided to have open surgery and reside abroad were excluded from the study. Pre-operative, intraoperative, and post-operative factors of all patients, which were considered to impact the development of complications, were noted down. Results: A total of 357 patients were included in the study. A total of 24 (6.7%) patients had epigastric trocar site infection (EPSI). It was found out that trocar site hematoma was a risk factor causing a 39.37-fold increase in the development of EPSI (<0.001) (95% confidence interval =10.69–144.97), while dilatation at the trocar site was a risk factor causing a 3.1-fold increase (p=0.027) (95% confidence interval =1.14–8.48). Ten patients had epigastric trocar insertion site hernia (EPSH). As a result of the multivariant analysis, it was determined that the development of EPSI caused the development of EPSH 27.59 times more (95% confidence interval =5.92–128.7) (p<0.001), while the accompanying additional laparoscopic procedure caused the development of EPSH 6.2 times more (95% confidence interval =6.2–1.17) (p=0.032). Conclusion: Preventing the occurrence of hematoma in the epigastric trocar insertion site, where the specimen is excised after LC surgery, reduces the risk of EPSI, and indirectly reduces the incidence of EPSH. Moreover, we recommend careful follow-up for EPSH in patients who underwent additional laparoscopic surgery during LC.

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Cite This Article

ÇELİK, S., SEVMİŞ, M., ZARBALIYEV, E., ÇAĞLIKÜLELÇİ, M., ÖZDEMİR, A. (2022). Epigastric port site complications and affecting factors used for gallbladder specimen extraction in laparoscopic cholecystectomy. Laparoscopic Endoscopic Surgical Science, Cilt: 29 - Sayı: 2, 65–74. https://ajindex.com/articles/423523

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References (13)

  1. Hassler KR, Collins JT, Philip K, Jones MW. Laparoscopic cholecys tectomy. 2022 Apr 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–
  2. Alexander HC, Bartlett AS, Wells CI, Hannam JA, Moore MR, Poole GH, Merry AF. Reporting of complications after laparoscopic cholecystectomy: a systematic review. HPB (Oxford) 2018;20:786–94
  3. Dalwani AG. Postoperative port site early complications of laparoscopic cholecystectomy. J Surg Pak 2021;26:79–83
  4. La Regina D, Mongelli F, Cafarotti S, Saporito A, Ceppi M, Di Giuseppe M, et al. Use of retrieval bag in the prevention of wound infection in elective laparoscopic cholecystectomy: is it evidence-based? A meta-analysis. BMC Surg 2018;18:102
  5. Kulkarni AA, Sharma G, Deo KB, Jain T. Umbilical port versus epigastric port for gallbladder extraction in laparoscopic cholecystectomy: A systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Surgeon 2022;20:e26–e35
  6. Al-Naser MK. Port Site Infections after laparoscopic cholecystectomy. Int J Med Res Health Sci 2017;6:132–7
  7. Nofal MN, Yousef AJ, Hamdan FF, Oudat AH. Characteristics of trocar site hernia after laparoscopic cholecystectomy. Sci Rep 2020;10:2868
  8. Hajibandeh S, Hajibandeh S, Clark MC, Barratt OA, Taktak S, Subar D, et al. Retrieval of gallbladder via umbilical versus epigastric port site during laparoscopic cholecystectomy: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech 2019;29:321–7
  9. Gutierrez M, Stuparich M, Behbehani S, Nahas S. Does closure of fascia, type, and location of trocar influence occurrence of port site hernias? A literature review. Surg Endosc 2020;34:5250–8
  10. Sood S, Imsirovic A, Sains P, Singh KK, Sajid MS. Epigastric port retrieval of the gallbladder following laparoscopic cholecystectomy is associated with the reduced risk of port site infection and port site incisional hernia: An updated metaanalysis of randomized controlled trials. Ann Med Surg (Lond) 2020;55:244–51
  11. Centers for Disease Control and Prevention. Surgical Site Infection (SSI) Events 2021. Available at: https://www.cdc. gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. Accessed Jun 14, 2022
  12. Barrett M, Asbun HJ, Chien HL, Brunt LM, Telem DA. Bile duct injury and morbidity following cholecystectomy: a need for improvement. Surg Endosc 2018;32:1683–8
  13. Gupta V, Gupta V, Joshi P, Kumar S, Kulkarni R, Chopra N, et al. Management of post cholecystectomy