Factores asociados a colecistectomía difícil en adultos del Hospital Militar Central entre Enero de 2018 a Diciembre del 2019

Introduction: Cholecystectomy is one of the most frequent surgeries in adult patients, difficult cholecystectomy represents between 10% and 15%, therefore it is important to establish the factors associated with its presentation to reduce associated morbidity. Objective: Determine the existence of factors associated with difficult cholecystectomy in adult patients evaluated by the General Surgery service of the Hospital Militar Central, in Bogota, Colombia between January 2018 and December 2019. Materials and methods: Analytical case-control study nested in a cohort of patients with cholelithiasis and acute cholecystitis who underwent cholecystectomy. 656 patients were taken, with 294 cases and 362 controls. A descriptive analysis of the independent variables, a bivariate analysis of a conditional logistic regression model, backward method, interaction evaluation, confusion, collinearity was performed. Evaluation of the precision of the model with the Akaike measure. Associations were expressed with odds ratios. Results: The prevalence of difficult cholecystectomy is 44.5%, being more frequent in men over 45 years of age with overweight and diabetes with a p <0.05. Three factors were found associated with a 95% CI. Conclusions: Difficult cholecystectomy is prevalent in the Central Military Hospital, occurring mainly in elderly men, associated with the presence of Tokio II cholecystitis and imaging findings of cholelithiasis with acute cholecystitis with a stone embedded in the neck, it is a call to have a clinical suspicion timely to provide priority surgical management to these patients and avoid their complications.