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Laparoscopic Cholecystectomy Operative Time and Hospital Stay Differences Between Sicklers and Non-sicklers: A
Lamair A Albakri1,2, Reem A Algarni3,4, Rawan K Alrajhi5
1Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Insights
Sickle cell disease (SCD) patients undergoing laparoscopic cholecystectomy (LC) have longer hospital stays. Standardizing preoperative care for SCD patients is crucial to improve outcomes and reduce hospitalization time.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Oncology
Background:
- Sickle cell disease (SCD) is a leading cause of pigment gallstones.
- Laparoscopic cholecystectomy (LC) is a safe treatment for gallstones in SCD patients.
- Current preoperative preparation for SCD patients undergoing LC lacks standardized guidelines.
Purpose of the Study:
- To compare preoperative, operative, postoperative, and total hospital stay durations for SCD and non-SCD patients undergoing LC.
- To identify potential areas for improving peri-operative management in SCD patients.
Main Methods:
- Retrospective comparative cross-sectional study of 793 LC patients (2013-2018).
- Data collected included demographics, clinical presentation, admission type, and various hospitalization lengths.
- Statistical analysis performed using JMP 15.2.1.
Main Results:
- SCD patients experienced significantly longer preoperative, postoperative, and total hospital stays (p<0.001).
- Operative time for LC did not significantly differ between SCD and non-SCD groups.
- SCD patients constituted 2.018% of the total LC cohort.
Conclusions:
- SCD is a significant risk factor for gallstone formation requiring LC.
- Peri-operative management presents challenges for SCD patients undergoing LC.
- Further research is needed to develop standardized peri-operative protocols for SCD patients to optimize care and reduce hospital stays.
Abstract:
Background Sickle cell disease (SCD) is one of the most important hemoglobinopathies that result in the formation of pigment gallstones. Laparoscopic cholecystectomy (LC) is a safe surgical procedure for gallstones in SCD. Currently, there is no standard or guidelines for the preoperative preparation of these patients. This study aims to estimate the difference in pre-operative length of stay, operative time, postoperative length of stay, and total hospitalization length of stay among patients with and without SCD in a tertiary hospital in Jeddah, Saudi Arabia. Such knowledge would aid in establishing a standard for the preoperative preparation of SCD patients for LC. Methods Data from all patients undergoing laparoscopic cholecystectomy between January 2013 and December 2018 were collected retrospectively with a comparative cross-sectional study design. Data included age, sex, BMI, clinical presentation, mode of admission (elective or emergency), preoperative length of stay, operative time, postoperative length of stay, total hospitalization length of stay, and type of surgery (day or inpatient). JMP 15.2.1 was used for statistical analysis. Results From 2013 to 2018, 793 patients underwent LC, and of those, 16 (2.018%) were SCD patients. The results showed significant differences in preoperative (p<0.001), postoperative (p<0.001), and total hospitalization stay time (p<0.001) between the SCD patients and non-SCD patients. However, the data show no significant difference in the operative time of LC between the two studied groups. Conclusion SCD is the most common hemoglobinopathy-causing gallstone. Challenges in these patients are mainly in peri-operative management. Further prospective cohort studies are needed to create a standardized approach for peri-operative management of SCD patients to facilitate delivery of the same level of care and shorten total hospitalization time.
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