Outcomes of Laparoscopic Cholecystectomy in Patients with End-Stage Renal Disease
Affiliation(s)
Department of General Surgery, School of Medicine, Baskent University, Ankara, Turkey.
Department of General Surgery, School of Medicine, Baskent University, Ankara, Turkey.
ABSTRACT
Purpose: In this study, we aimed to discuss the laparoscopic cholecystectomy in patients with end stage renal disease compared to the general population. Materials and Methods: We retrospectively evaluated a group of patients with (n = 45) and without (n = 90) end-stage renal disease undergoing laparoscopic cholecystectomy. The groups were compared in terms of length of surgery; duration of hospitalization after surgery; use of blood derivatives; mortality rates; and perioperative, postoperative, and postdischarge complications. Results: Patients with end-stage renal disease exhibited a higher frequency of associated diseases; lower hemoglobin levels; and elevated alkaline phosphatase, blood urea nitrogen, and creatinine values. Statistically significant differences were found between the two groups regarding length of surgery (83.6 ± 14.88 vs. 71.7 ± 11.42 minutes; p < 0.001); duration of hospitalization (1.7 ± 0.47 vs. 1.4 ± 0.31 days; p < 0.001). In the group of patients with end-stage renal disease had significantly higher perioperative (p = 0.011), postoperative (p < 0.001), and postdischarge complication (p = 0.011) rates. Among all patients with end-stage renal disease, 12 (26.7%) were converted to an open procedure (p < 0.001). Conclusion: Despite higher complication rates of laparoscopic cholecystectomy in end-stage renal disease patients, laparoscopic cholecystectomy could be performed safely in patients with end-stage renal disease with low levels of complications and no associated mortality.
Purpose: In this study, we aimed to discuss the laparoscopic cholecystectomy in patients with end stage renal disease compared to the general population. Materials and Methods: We retrospectively evaluated a group of patients with (n = 45) and without (n = 90) end-stage renal disease undergoing laparoscopic cholecystectomy. The groups were compared in terms of length of surgery; duration of hospitalization after surgery; use of blood derivatives; mortality rates; and perioperative, postoperative, and postdischarge complications. Results: Patients with end-stage renal disease exhibited a higher frequency of associated diseases; lower hemoglobin levels; and elevated alkaline phosphatase, blood urea nitrogen, and creatinine values. Statistically significant differences were found between the two groups regarding length of surgery (83.6 ± 14.88 vs. 71.7 ± 11.42 minutes; p < 0.001); duration of hospitalization (1.7 ± 0.47 vs. 1.4 ± 0.31 days; p < 0.001). In the group of patients with end-stage renal disease had significantly higher perioperative (p = 0.011), postoperative (p < 0.001), and postdischarge complication (p = 0.011) rates. Among all patients with end-stage renal disease, 12 (26.7%) were converted to an open procedure (p < 0.001). Conclusion: Despite higher complication rates of laparoscopic cholecystectomy in end-stage renal disease patients, laparoscopic cholecystectomy could be performed safely in patients with end-stage renal disease with low levels of complications and no associated mortality.
Cite this paper
Ekici, Y. , Tezcaner, T. , Aydoğan, C. , Karakayalı, F. and Moray, G. (2014) Outcomes of Laparoscopic Cholecystectomy in Patients with End-Stage Renal Disease. International Journal of Clinical Medicine, 5, 1300-1305. doi: 10.4236/ijcm.2014.520165.
Ekici, Y. , Tezcaner, T. , Aydoğan, C. , Karakayalı, F. and Moray, G. (2014) Outcomes of Laparoscopic Cholecystectomy in Patients with End-Stage Renal Disease. International Journal of Clinical Medicine, 5, 1300-1305. doi: 10.4236/ijcm.2014.520165.
References
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http://dx.doi.org/10.1111/j.1572-0241.2003.07382.x [2] Korzets, Z., Golan, E., Ben-Chitrit, S., Schneider, N., Chagnac, A., Carel, R. and Bernheim, J. (1998) Prevalence of Cholelithiasis in Non-Diabetic Haemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients. Nephron, 1, 44-47.
http://dx.doi.org/10.1159/000044881 [3] Hojs, R. (1995) Cholecystolithiasis in Patients with End-Stage Renal Disease Treated with Haemodialysis: A Study of Prevalence. American Journal of Nephrology, 1, 15-17.
http://dx.doi.org/10.1159/000168796 [4] National Institutes of Health Consensus (1993) National Institutes of Health Consensus Development Conference Statement on Gallstones and Laparoscopic Cholecystectomy. American Journal of Surgical Pathology, 165, 390-398. [5] Keus, F., de Jong, J.A., Gooszen, H.G. and van Laarhoven, C.J. (2006) Laparoscopic versus Open Cholecystectomy for Patients with Symptomatic Cholecystolithiasis. Cochrane Database of Systematic Reviews, 18, Article ID: CD006231. [6] Yeh, C.N., Chen, M.F. and Jan, Y.Y. (2005) Laparoscopic Cholecystectomy for 58 End Stage Renal Disease Patients. Surgical Endoscopy, 19, 915-918.
http://dx.doi.org/10.1007/s00464-004-2207-2 [7] Miles, A.M. and Friedman, E.A. (1997) Center and Home Hemodialysis: Outcome and Complication. In: Schrier, R.W. and Gottschalk, C.W., Eds., Diseases of the Kidney, Little Brown, Boston, 2807-2838. [8] Martin, P. and Fabrizi, F. (2008) Hepatitis C Virus and Kidney Disease. Journal of Hepatology, 49, 613-624.
http://dx.doi.org/10.1016/j.jhep.2008.06.003 [9] Fabrizi, F., Messa, P. and Martin, P. (2008) Hepatitis B Virus Infection and the Dialysis Patient. Seminars in Dialysis, 21, 440-446.
http://dx.doi.org/10.1111/j.1525-139X.2008.00437.x [10] Pol, S., Thiers, V., Carnot, F., Zins, B., Romeo, R., Berthelot, P. and Bréchot, C. (1995) Efficacy and Tolerance of Alpha-2b Interferon Therapy on HCV Infection of Hemodialyzed Patients. Kidney International, 47, 1412-1418.
http://dx.doi.org/10.1038/ki.1995.198 [11] Chan, T.M. (1996) Hepatitis C Virus Infection in Patients on Renal Replacement Therapy. Nephrology, 2, S85-S87.
http://dx.doi.org/10.1111/j.1440-1797.1996.tb00147.x [12] Wolf, P.L., William, D., Coplon, N. and Coulson, A.S. (1972) Low Aspartate Transaminase Activity in Serum of Patients Undergoing Chronic Hemodialysis. Clinical Chemistry, 18, 567-573. [13] Rostaing, L., Izopet, J., Cisterne, J.M., Icart, J., Chabannier, M.H., Panicali, H. and Durand, D. (1997) Prevalence of Antibodies to Hepatitis C Virus and Correlation with Liver Disease in Renal Transplant Patients. American Journal of Nephrology, 17, 46-52.
http://dx.doi.org/10.1159/000169071 [14] Lowell, J.A., Stratta, R.J., Taylor, R.J., Bynon, J.S., Larsen, J.L. and Nelson, N.L. (1993) Cholelithiasis in Pancreas and Kidney Transplant Recipients with Diabetes. Surgery, 114, 858-863. [15] Kazama, J.J., Kazama, S., Koda, R., Yamamoto, S., Narita, I. and Gejyo, F. (2009) The Risk of Gallbladder Stone Formation Is Increased in Patients with Predialysis Chronic Kidney Disease but Not Those Undergoing Chronic Hemodialysis Therapy. Nephron Clinical Practice, 111, c167-c172.
http://dx.doi.org/10.1159/000199456 [16] Ekici, Y., Karakayali, F., Yagmurdur, M.C., Moray, G., Karakayali, H. and Haberal, M. (2009) Laparoscopic Cholecystectomy in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: A Case-Control Study. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 19, 101-105.
http://dx.doi.org/10.1097/SLE.0b013e31819f32f5 [17] Jackson, T., Treleaven, D., Arlen, D., D’Sa, A., Lambert, K. and Birch, D.W. (2005) Management of Asymptomatic Cholelithiasis for Patients Awaiting Renal Transplantation. Surgical Endoscopy, 19, 510-513.
http://dx.doi.org/10.1007/s00464-004-8817-x [18] Peters, J.H., Krailadsiri, W., Incarbone, R., Bremner, C.G., Froes, E., Ireland, A.P., Crookes, P., Ortega, A.E., Anthone G.A. and Stain, S.A. (1994) Reasons for Conversion from Laparoscopic to Open Cholecystectomy in an Urban Teaching Hospital. The American Journal of Surgery, 168, 555-558.
http://dx.doi.org/10.1016/S0002-9610(05)80121-7 [19] Rosen, M., Brody, F. and Ponsky, J. (2002) Predictive Factors for Conversion of Laparoscopic Cholecystectomy. The American Journal of Surgery, 184, 254-258.
http://dx.doi.org/10.1016/S0002-9610(02)00934-0 [20] Roubicek, T., Bartlova, M., Krajickova, J., Haluzikova, D., Mraz, M., Lacinova, Z., Kudla, M., Teplan, V. and Haluzik, M. (2009) Increased Production of Proinflammatory Cytokines in Adipose Tissue of Patients with End-Stage Renal Disease. Nutrition, 25, 762-768.
http://dx.doi.org/10.1016/j.nut.2008.12.012
[1] Altiparmak, M.R., Pamuk, O.N., Pamuk, G.E., Celik, A.F., Apaydin, S., Cebi, D., Mihmanli, I. and Erek, E. (2003) Incidence of Gallstones in Chronic Renal Failure Patients Undergoing Hemodialysis: Experience of a Center in Turkey. The American Journal of Gastroenterology, 4, 813-820.
http://dx.doi.org/10.1111/j.1572-0241.2003.07382.x [2] Korzets, Z., Golan, E., Ben-Chitrit, S., Schneider, N., Chagnac, A., Carel, R. and Bernheim, J. (1998) Prevalence of Cholelithiasis in Non-Diabetic Haemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients. Nephron, 1, 44-47.
http://dx.doi.org/10.1159/000044881 [3] Hojs, R. (1995) Cholecystolithiasis in Patients with End-Stage Renal Disease Treated with Haemodialysis: A Study of Prevalence. American Journal of Nephrology, 1, 15-17.
http://dx.doi.org/10.1159/000168796 [4] National Institutes of Health Consensus (1993) National Institutes of Health Consensus Development Conference Statement on Gallstones and Laparoscopic Cholecystectomy. American Journal of Surgical Pathology, 165, 390-398. [5] Keus, F., de Jong, J.A., Gooszen, H.G. and van Laarhoven, C.J. (2006) Laparoscopic versus Open Cholecystectomy for Patients with Symptomatic Cholecystolithiasis. Cochrane Database of Systematic Reviews, 18, Article ID: CD006231. [6] Yeh, C.N., Chen, M.F. and Jan, Y.Y. (2005) Laparoscopic Cholecystectomy for 58 End Stage Renal Disease Patients. Surgical Endoscopy, 19, 915-918.
http://dx.doi.org/10.1007/s00464-004-2207-2 [7] Miles, A.M. and Friedman, E.A. (1997) Center and Home Hemodialysis: Outcome and Complication. In: Schrier, R.W. and Gottschalk, C.W., Eds., Diseases of the Kidney, Little Brown, Boston, 2807-2838. [8] Martin, P. and Fabrizi, F. (2008) Hepatitis C Virus and Kidney Disease. Journal of Hepatology, 49, 613-624.
http://dx.doi.org/10.1016/j.jhep.2008.06.003 [9] Fabrizi, F., Messa, P. and Martin, P. (2008) Hepatitis B Virus Infection and the Dialysis Patient. Seminars in Dialysis, 21, 440-446.
http://dx.doi.org/10.1111/j.1525-139X.2008.00437.x [10] Pol, S., Thiers, V., Carnot, F., Zins, B., Romeo, R., Berthelot, P. and Bréchot, C. (1995) Efficacy and Tolerance of Alpha-2b Interferon Therapy on HCV Infection of Hemodialyzed Patients. Kidney International, 47, 1412-1418.
http://dx.doi.org/10.1038/ki.1995.198 [11] Chan, T.M. (1996) Hepatitis C Virus Infection in Patients on Renal Replacement Therapy. Nephrology, 2, S85-S87.
http://dx.doi.org/10.1111/j.1440-1797.1996.tb00147.x [12] Wolf, P.L., William, D., Coplon, N. and Coulson, A.S. (1972) Low Aspartate Transaminase Activity in Serum of Patients Undergoing Chronic Hemodialysis. Clinical Chemistry, 18, 567-573. [13] Rostaing, L., Izopet, J., Cisterne, J.M., Icart, J., Chabannier, M.H., Panicali, H. and Durand, D. (1997) Prevalence of Antibodies to Hepatitis C Virus and Correlation with Liver Disease in Renal Transplant Patients. American Journal of Nephrology, 17, 46-52.
http://dx.doi.org/10.1159/000169071 [14] Lowell, J.A., Stratta, R.J., Taylor, R.J., Bynon, J.S., Larsen, J.L. and Nelson, N.L. (1993) Cholelithiasis in Pancreas and Kidney Transplant Recipients with Diabetes. Surgery, 114, 858-863. [15] Kazama, J.J., Kazama, S., Koda, R., Yamamoto, S., Narita, I. and Gejyo, F. (2009) The Risk of Gallbladder Stone Formation Is Increased in Patients with Predialysis Chronic Kidney Disease but Not Those Undergoing Chronic Hemodialysis Therapy. Nephron Clinical Practice, 111, c167-c172.
http://dx.doi.org/10.1159/000199456 [16] Ekici, Y., Karakayali, F., Yagmurdur, M.C., Moray, G., Karakayali, H. and Haberal, M. (2009) Laparoscopic Cholecystectomy in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: A Case-Control Study. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 19, 101-105.
http://dx.doi.org/10.1097/SLE.0b013e31819f32f5 [17] Jackson, T., Treleaven, D., Arlen, D., D’Sa, A., Lambert, K. and Birch, D.W. (2005) Management of Asymptomatic Cholelithiasis for Patients Awaiting Renal Transplantation. Surgical Endoscopy, 19, 510-513.
http://dx.doi.org/10.1007/s00464-004-8817-x [18] Peters, J.H., Krailadsiri, W., Incarbone, R., Bremner, C.G., Froes, E., Ireland, A.P., Crookes, P., Ortega, A.E., Anthone G.A. and Stain, S.A. (1994) Reasons for Conversion from Laparoscopic to Open Cholecystectomy in an Urban Teaching Hospital. The American Journal of Surgery, 168, 555-558.
http://dx.doi.org/10.1016/S0002-9610(05)80121-7 [19] Rosen, M., Brody, F. and Ponsky, J. (2002) Predictive Factors for Conversion of Laparoscopic Cholecystectomy. The American Journal of Surgery, 184, 254-258.
http://dx.doi.org/10.1016/S0002-9610(02)00934-0 [20] Roubicek, T., Bartlova, M., Krajickova, J., Haluzikova, D., Mraz, M., Lacinova, Z., Kudla, M., Teplan, V. and Haluzik, M. (2009) Increased Production of Proinflammatory Cytokines in Adipose Tissue of Patients with End-Stage Renal Disease. Nutrition, 25, 762-768.
http://dx.doi.org/10.1016/j.nut.2008.12.012