American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Tough cholecystectomies are easy to predict

OCTOBER 26, 2017
Clinical Congress Daily Highlights, Thursday Edition

Although laparoscopic cholecystectomy (LC) is one of the most commonly performed abdominal surgical procedures and can be straightforward to perform, some cases require lengthy operative times and may have intraoperative complications or require conversion to an open procedure.

A study led by Jeffrey W. Santos, Boston University School of Medicine, MA, reviewed 400 consecutive LCs that took place over a 20-month period at a tertiary urban academic medical center. The researchers were able to identify several preoperative risk factors that predict these difficult LCs, including male gender, more comorbidities, higher BMI, previous open abdominal surgery, and a higher white cell count. Surgeon or resident seniority, time from symptoms to surgery, and presence of choledocholithiasis did not affect outcomes or extend operative times.

The authors conclude that knowledge of the above factors may alert surgeons to the possibility of a challenging cholecystectomy. Model prediction was very good with the area under the receiver operating characteristic curve (AUC) equal to 0.80.

Additional Information:

This Scientific Forum study was presented October 26 at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA. Program, webcast and audio information is available online at

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