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<p>Laparoscopic cholecystectomy (LC) is the standard surgical treatment for gallstone disease (GSD). Despite its minimally invasive advantages, port site infection (PSI) remains a notable postoperative complication. Metabolic factors implicated in gallstone formation, such as elevated serum cholesterol, may also influence wound healing and infection risk. This study aimed to evaluate the association between preoperative serum cholesterol levels and the occurrence of PSI following LC.&#xa0;Assuming an expected PSI incidence of 4.5% and a 15–20% higher risk in patients with elevated serum cholesterol (&gt; 200&#xa0;mg/dL), the sample size was calculated using 95% confidence and 80% power. This yielded a requirement of approximately 50–55 participants, and this prospective observational study included 56 patients aged 18–70 years (ASA grade I/II) undergoing elective LC for cholelithiasis. Patients on statins or long-term steroids and those converted to open surgery were excluded. Preoperative evaluation included serum lipid profile, HbA1c, and BMI. Intraoperative parameters such as surgery duration, gallbladder condition (Parkland grading), and bile or stone spillage were recorded. Port site wounds were assessed on postoperative days 3, 7, 14, and 30 using the Centres for Disease Control and Prevention (CDC) criteria for surgical site infection. Data were analysed using Chi-square tests and logistic regression (SPSS v21), with <i>p</i> &lt; 0.05 considered significant.&#xa0;The mean patient age was 43.6 years; 69.6% were female. Four patients (7.14%) developed superficial PSI at the epigastric port, with one requiring re-admission. Elevated serum cholesterol (&gt; 200&#xa0;mg/dL) was significantly associated with PSI (<i>p</i> = 0.001), with an odds ratio of 12.6 (95% CI: 1.19–133.7). No significant associations were noted with BMI (<i>p</i> = 0.058), HbA1c, age, gender, or intraoperative variables.&#xa0;Preoperative hypercholesterolemia is significantly associated with an increased risk of PSI following LC. Patients with high preoperative serum cholesterol (&gt; 200&#xa0;mg/dL) had a higher risk of developing port-site SSI in this study. Therefore, preoperative counselling on behavioural and dietary modifications aimed at reducing and optimizing serum cholesterol levels may help decrease the incidence of SSI after laparoscopic cholecystectomy. Larger multicentric studies are warranted to validate these findings.</p>

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Surgical Site Infection After Laparoscopic Cholecystectomy and Its Association With Serum Cholesterol Levels

  • 期刊论文

  • 发表日期：

    2026年5月6日

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  • Saroj Kumar Yadav,
  • Divya Dahiya,
  • Gopika V.G,
  • Basil Babu,
  • Cherring Tandup,
  • Kailash Chand Kurdia

摘要

Laparoscopic cholecystectomy (LC) is the standard surgical treatment for gallstone disease (GSD). Despite its minimally invasive advantages, port site infection (PSI) remains a notable postoperative complication. Metabolic factors implicated in gallstone formation, such as elevated serum cholesterol, may also influence wound healing and infection risk. This study aimed to evaluate the association between preoperative serum cholesterol levels and the occurrence of PSI following LC. Assuming an expected PSI incidence of 4.5% and a 15–20% higher risk in patients with elevated serum cholesterol (> 200 mg/dL), the sample size was calculated using 95% confidence and 80% power. This yielded a requirement of approximately 50–55 participants, and this prospective observational study included 56 patients aged 18–70 years (ASA grade I/II) undergoing elective LC for cholelithiasis. Patients on statins or long-term steroids and those converted to open surgery were excluded. Preoperative evaluation included serum lipid profile, HbA1c, and BMI. Intraoperative parameters such as surgery duration, gallbladder condition (Parkland grading), and bile or stone spillage were recorded. Port site wounds were assessed on postoperative days 3, 7, 14, and 30 using the Centres for Disease Control and Prevention (CDC) criteria for surgical site infection. Data were analysed using Chi-square tests and logistic regression (SPSS v21), with p < 0.05 considered significant. The mean patient age was 43.6 years; 69.6% were female. Four patients (7.14%) developed superficial PSI at the epigastric port, with one requiring re-admission. Elevated serum cholesterol (> 200 mg/dL) was significantly associated with PSI (p = 0.001), with an odds ratio of 12.6 (95% CI: 1.19–133.7). No significant associations were noted with BMI (p = 0.058), HbA1c, age, gender, or intraoperative variables. Preoperative hypercholesterolemia is significantly associated with an increased risk of PSI following LC. Patients with high preoperative serum cholesterol (> 200 mg/dL) had a higher risk of developing port-site SSI in this study. Therefore, preoperative counselling on behavioural and dietary modifications aimed at reducing and optimizing serum cholesterol levels may help decrease the incidence of SSI after laparoscopic cholecystectomy. Larger multicentric studies are warranted to validate these findings.