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Impact of patient factors on operative duration during laparoscopic cholecystectomy: evaluation from the National
Bethany Lowndes1, Cornelius A Thiels2, Elizabeth B Habermann2
1Mayo Clinic, Health Sciences Research, 200 First Street SW, Rochester, MN 55905, USA; Department of Mechanical and Material Engineering, University of Nebraska-Lincoln, 1400 R Street, Lincoln, NE 68588, USA.
Background:
Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration.
Methods:
The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all elective LC for biliary colic from 2005 to 2013. Multivariate general linear model and logistic regression were used to evaluate patient factors as predictors of operative duration greater than 60 minutes, adjusted for resident involvement and cholangiography.
Results:
A total of 24,099 LC met inclusion criteria. Regression analysis found procedure duration greater than 60 minutes was less likely for patients age greater than 40 and less than 30 (P < .001) and more likely for men (P < .05), body mass index (BMI) greater than 30 compared with BMI 18.5 to 24.9 (P < .05), abnormal liver function test (LFT) (P < .05), and higher ASA class (P < .05). Smoking, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and abnormal white blood cell count were not significant predictors.
Conclusions:
Higher BMI, younger age, male gender, higher ASA, and abnormal LFTs are possible predictors of prolonged LC duration and can aid in operating room scheduling and utilization.
