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Surgical complications in hepatitis C patients undergoing cholecystectomy
Rachel L Su1, Shawn A C Rosario1, Armin Chaychian1
1Morsani College of Medicine, University of South Florida, Tampa, FL, United States.
Insights
Patients with Hepatitis C (HCV) infection, whether treated or untreated, experience similar cholecystectomy outcomes as those without HCV. Antiviral treatment status should not delay gallbladder removal surgery.
Area of Science:
- Hepatology
- Surgical Outcomes
- Infectious Diseases
Background:
- Hepatitis C (HCV) infection impacts over 2.2 million in the US, linked to liver cirrhosis and gallstones.
- Cholecystectomy outcomes in HCV patients remain understudied.
- This research compares surgical results in patients with treated, untreated, and no history of HCV infection.
Purpose of the Study:
- To evaluate and compare cholecystectomy outcomes.
- To assess postoperative complication rates and severity.
- To determine if HCV treatment status impacts surgical results.
Main Methods:
- A retrospective cohort study analyzed over 12 years of data.
- Patients with Hepatitis B or HIV were excluded.
- HCV-negative patients were matched to HCV-positive patients by age, sex, and race/ethnicity.
Main Results:
- The study included 66 untreated HCV, 33 treated HCV, and 324 matched HCV-negative patients.
- Overall postoperative complication rates were similar across groups (10.9%, P=.71).
- No significant differences were found in complication severity, ICU admission, or reoperation rates.
Conclusions:
- HCV patients tolerate cholecystectomy similarly to controls, despite longer hospital stays and higher transfusion rates.
- Postoperative complication rates and severity are comparable between treated, untreated HCV, and non-HCV groups.
- Antiviral treatment status should not postpone cholecystectomy in HCV patients.
Background:
Hepatitis C (HCV) infection affects more than 2.2 million people in the United States and is associated with liver cirrhosis and gallstone formation. However, cholecystectomy outcomes of patients with and without HCV infection are not well studied. This study aimed to examine the differences in cholecystectomy outcomes among patients with untreated, treated, and no HCV infection history.
Methods:
A retrospective cohort study was conducted at a single institution that included data of more than 12 years. Patients were excluded if they had a previous chronic hepatitis B or HIV diagnosis. Patients without HCV infection were matched to patients with HCV infection based on age, sex (male or female), and race/ethnicity.
Results:
This study identified 66 patients with untreated HCV infection and 33 patients with treated HCV infection. Furthermore, 324 patients without HCV infection were matched to the cohort HCV infection. The overall postoperative complication rate was 10.9%. There was no statistically significant difference in postoperative complication rates between the groups (P = .71). There was no significant difference in the level of intervention required to treat these complications according to the Clavien-Dindo classification (P = .97), postoperative intensive care unit admission (P = .43), or reoperation rate (P = .45).
Conclusion:
Despite having a longer mean length of stay and increased risk of intraoperative blood product transfusion, both patients with untreated HCV infection and those with treated HCV infection had similar rates of postoperative complications and complication severity compared with controls. Our findings suggest that patients with HCV infection tolerate cholecystectomy at a comparable level to patients without HCV infection. The lack of difference in postoperative complication rates between patients with untreated and treated HCV infection indicates that lack of antiviral treatment should not delay cholecystectomy.
