Reingresos tras colecistectomía laparoscópica¿Influye la realización de una CPRE previa a la colecistectomía?
- Raquel Latorre Fragua 1
- A. Manuel Vázquez 1
- Carmen Ramiro 1
- Anibal Medina Velasco 1
- Aylhin Joana López Marcano 1
- Vladimir Arteaga Peralta 1
- Roberto de la Plaza Llamas 1
- José Manuel Ramia Ángel 1
- 1 Hospital Universitario de Guadalajara. Guadalajara
ISSN: 2340-416, 1130-0108
Year of publication: 2019
Volume: 111
Issue: 6
Pages: 460-466
Type: Article
More publications in: Revista Española de Enfermedades Digestivas
Abstract
Aim: the aim of this study was to assess the reasons for and the time of hospital readmissions after cholecystectomy, according to whether an endoscopic retrograde cholangiopancreatography (ERCP) was performed. Method: all patients that underwent cholecystectomy at the Service of Digestive Diseases and General Surgery of the Hospital Universitario de Guadalajara between January 2011 and December 2016 were retrospectively reviewed. Patients who underwent cholecystectomy and were readmitted to any hospital service within 90 days of surgery were included. The following cases were excluded: patients that underwent cholecystectomy in combination with other procedures, an active oncological pathology at the time of cholecystectomy, admissions previously scheduled for another unrelated pathology and those with tumor histology in the cholecystectomy specimen. Results: of a total of 1,714 patients, 80 were readmitted within 90 days of discharge after cholecystectomy, which equates to a readmission rate of 4.6%. The performance of an ERCP prior to surgery was associated with an increase in postoperative morbidity (40% vs 21.54%). A prior ERCP reduced the rate of biliary complications during the 90 days after cholecystectomy. Furthermore, there was an increase in the number of days prior to readmission in these cases, with a mean period of 22 days with ERCP vs seven days without ERCP. Conclusion: patients in our series who required an ERCP prior to cholecystectomy had a greater postoperative morbidity. However, those that did not require ERCP had more biliary complications and were readmitted earlier.