Clinical-Epidemiological Characteristics of Patients Undergoing Laparoscopic Cholecystectomy and its Relationship With the Parkland Classification.

Abstract

Introduction: Biliary stone disease is the most common condition that affects the gallbladder and biliary tree. The Parkland Cholecystitis Scale (PCS) is a tool for staging the severity of gallbladder disease using intraoperative imaging. The main objective of this study is to describe the clinical-epidemiological characteristics of patients undergoing laparoscopic cholecystectomy (LC) in the period from March 2018 to December 2021, with the secondary objective being to investigate whether there is a relationship between the presence of presurgical leukocytosis and grades 3, 4 and 5 in the PCS. Methods: This is a cross-sectional and single center study, which exhaustively analyze patients undergoing LC at the Institute of Security and Social Services of State Workers (ISSSTE by its acronym in Spanish) León Regional Hospital, in the period from March 2018 to December 2021. Results: A total of 289 patients were included in the study of which 214 (74%) were female and 75 (26%) were male, with a mean age of 50 ± 5.7 years. It was identified that being male, type 2 diabetes mellitus, as well as the presurgical presence of leukocytosis (≥ 10x 10⁹/L), hyperbilirubinemia (total bilirubin ≥ 1.2 mg/dl), thickened gallbladder wall reported by ultrasound (≥ 4 mm), and bile duct dilation (> 6 mm) showed a statistically significant association with difficult cholecystectomies. Conclusion: It is essential to use different rescue tools or even consider converting to open surgery when faced with a patient with these characteristics to avoid an unfavorable outcome in patients with difficult cholecystectomy.