Title:Efficacy of Thiol Disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy
Volume: 24
Issue: 3
Author(s): Gökhan Akkurt*, Burcu Akkurt, Emel Alptekın, Birkan Birben, Mehmet Keşkek and Özcan Erel
Affiliation:
- Ankara City Hospital, General Surgery Universiteler, 1604. Cd. No: 9 D: No: 9, 06800, Ankara,Turkey
Keywords:
Thiol disulfide homeostasis, ischemia modified albumin, laparoscopic cholecystectomy, gallbladder, colescystitis,
adhesion score.
Abstract:
Aim: The aim of this study was to investigate the efficacy of thiol disulfide homeostasis
and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be
encountered during laparoscopic cholecystectomy.
Materials and Methods: The study included 65 patients who underwent laparoscopic
cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training
and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history
of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT),
amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gall
bladder, duration of hospital stay, duration of operation, thiol disulfide and IMA values were
evaluated.
Results: Native thiol and total thiol averages were higher in patients without a history of
cholecystitis, and on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate,
native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis.
While there was a statistically significant negative correlation between native and total thiol values
and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol,
Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer
duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total
thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of
intraoperative pericholecystic adhesion increased.
Conclusion: We believe that the evaluation of thiol disulfide homeostasis and IMA parameters
prior to laparoscopic cholecystectomy can be used as an effective method for predicting
intraoperative difficulties.