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镰状细胞病患者与非镰状细胞病患者腹腔镜胆囊切除术的手术时间和住院时间差异:在吉达阿卜杜勒阿齐兹国王医疗城进行的一项为期五年的比较横断面研究

Laparoscopic Cholecystectomy Operative Time and Hospital Stay Differences Between Sicklers and Non-sicklers: A Five-Year Comparative Cross-Sectional Study at King Abdulaziz Medical City, Jeddah.

作者信息

Albakri Lamair A, Algarni Reem A, Alrajhi Rawan K, Yousef Yasmin A, Zaidi Syed Faisal

机构信息

Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.

College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.

出版信息

Cureus. 2022 Oct 31;14(10):e30952. doi: 10.7759/cureus.30952. eCollection 2022 Oct.

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.

摘要

背景 镰状细胞病(SCD)是最重要的血红蛋白病之一,可导致色素性胆结石的形成。腹腔镜胆囊切除术(LC)是治疗SCD患者胆结石的一种安全手术方法。目前,对于这些患者的术前准备尚无标准或指南。本研究旨在评估沙特阿拉伯吉达一家三级医院中患有和未患有SCD的患者在术前住院时间、手术时间、术后住院时间和总住院时间上的差异。这些知识将有助于为SCD患者进行LC术前准备建立标准。方法 采用比较性横断面研究设计,回顾性收集2013年1月至2018年12月期间所有接受腹腔镜胆囊切除术患者的数据。数据包括年龄、性别、体重指数、临床表现、入院方式(择期或急诊)、术前住院时间、手术时间、术后住院时间、总住院时间以及手术类型(日间或住院)。使用JMP 15.2.1进行统计分析。结果 2013年至2018年,793例患者接受了LC,其中16例(2.018%)为SCD患者。结果显示,SCD患者与非SCD患者在术前(p<0.001)、术后(p<0.001)和总住院时间(p<0.001)上存在显著差异。然而,数据显示两个研究组之间LC的手术时间无显著差异。结论 SCD是导致胆结石最常见的血红蛋白病。这些患者面临的挑战主要在于围手术期管理。需要进一步开展前瞻性队列研究,以创建SCD患者围手术期管理的标准化方法,以便提供同等水平的护理并缩短总住院时间。

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