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Elective laparoscopic cholecystectomy: preoperative prediction of duration of surgery
B J Ammori1, M Larvin, M J McMahon
1Leeds Institute for Minimally Invasive Therapy (LIMIT), Wellcome Wing, The General Infirmary, Great George Street, Leeds LS1 3EX, UK.
Background:
Efficient use of operating time has become a key concern. The aim of this study was to determine preoperative factors that can predict extended duration of operating time (>90 min) for laparoscopic cholecystectomy (LC).
Methods:
Data collected prospectively on 827 consecutive patients who underwent elective LC between 1990 and 1997 were analyzed. Factors evaluated included age, gender; body mass index; comorbidity; duration of symptoms; history of jaundice, pancreatitis, or abdominal surgery; dilated common bile duct or thick-walled gallbladder on ultrasound; preoperative endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES); and surgeon experience. Univariate and multivariate analyses were performed to identify factors predicting a long operation.
Results:
Operating time was longer than 90 min in 276 patients (33%). Predictors of extended operation time were age older than 55 years (odds ratio [OR] = 9.7), preoperative ES (OR = 2.8), and a thick-walled gallbladder on ultrasound (OR = 2.5).
Conclusion:
These predictors may be useful in planning theater lists and anesthesia management, and in selecting patients for day surgery.