Multicenter and Multivariate Analysis of Complications Associated with Biliary and Vascular Anomalies in Patients Who Underwent Laparoscopic Cholecystectomy

BACKGROUND/AIMS:In this retrospective study, the aim was to analyze complications associated with biliary and vascular anomalies in patients who underwent cholecystectomy. MATERIALS AND METHODS:A total of 925 patients who underwent cholecystectomy between 1993 and 2018 were included in the study.The patients' gender, age, diagnosis, comorbidities, antibiotic use, drainage use and duration, operation, hospital stay, and complications were analyzed.RESULTS: Mean age was significantly higher in the no-anomaly group (p<0.05).Drainage and duration of hospitalization were significantly higher in the biliary anomaly group (p<0.05).Differences in gender, diagnosis, endoscopic retrograde cholangiopancreatography, hypertension, diabetes mellitus, chronic artery disease, chronic obstructive pulmonary disease, antibiotic usage, drainage, and operation duration between anomaly groups were not significant (p>0.05).Having an anomaly was significantly correlated with hospitalization duration (r=0.088;p<0.01).Biliary anomaly was also significantly correlated with hospitalization duration (r=0.105;p<0.05).Vascular anomaly was not significantly correlated with the research parameters (p>0.05).Complications were significantly correlated with gender (r=0.097;p<0.01), diagnosis (r=-0.072;p<0.05), operation duration (r=0.129;p<0.01), hospitalization duration (r=0.257;p<0.01), biliary anomaly (r=0.127;p<0.01), and no anomaly (r=-0.122,p<0.01).The effect of operation duration on complications was significant at the multivariate level (B=0.033;p<0.01).Receiver operating characteristic analysis showed that the area under the curve for operation time was 0.701, indicating that operation time has significant predictive value at the 70.1% level for complications in cholecystectomy patients.When operation time exceeded 29 minutes, sensitivity for complications was 82.8% and specificity was 37.7%.When operation time exceeded 31 minutes, sensitivity was 72.4% and specificity was 59.2% for complications.CONCLUSION: Prolonged operation times in cholecystectomy patients with biliary anomalies significantly increase the risk of complications compared with the non-anomaly and vascular anomaly groups.Depending on the duration of the operation, complications may be predicted and precautions taken.