Incidencia y factores de riesgo relacionados con las complicaciones ocacionadas por iatrogeneas transoperatoreas y postoperatoreas de la colecistectomia electiva y de emergencia

Abstract

Background: cholecystectomy is the most common abdominal surgery, and iatrogenic lesions are a relevant problem, difficult to diagnose and treat, requiring reconstruction associated with significant morbidity and mortality. Objective: to investigate the incidence and risk factors related to complications caused by transoperative and postoperative iatrogenic complications of elective and emergency cholecystectomy. Methodology: a literature review was conducted, in which studies of scientific relevance with levels of evidence II to IV were integrated, with an interquartile range of 1 to 4 according to Scimago Journal & Country Rank, and the information from 2018 to 2022, where the morbidity derived from iatrogenic cholecystectomy was highlighted. Results: the incidence of iatrogenic injuries reaches 0.52%. The majority of the complications develop in emergency surgery. Where male sex (OR 1.99), age >65 years (1.51), ≥80 years (1.95), acute cholecystitis (7. 36), chronic cholecystitis (3.13), presence of inflammatory infiltrate (2.38), peritoneal adhesions (3.17), C-reactive protein >91 (4.58), moderate malnutrition (1.83), severe malnutrition (3.09), >3 previous admissions (4, 6), lack of conversion to open surgery (5.79), emergency cholecystectomy (2.29), ASA ≥3 (1.70), prolonged operative time, and increased bleeding and bile duct ≤3 mm were risk factors. The most frequent lesion is of types E2 and 3 in the Strasberg classification. Conclusions: iatrogenic lesions in cholecystectomy still significantly risk the patient's quality of life and survival.