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Laparoscopic cholecystectomy: do risk factors for a prolonged length of stay exist?
Valter Ripetti1, Paolo Luffarelli2, Simone Santoni1
1General Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
Insights
Identifying patients at high risk for prolonged hospitalization after laparoscopic cholecystectomy is crucial. Patient age, not surgical complications, is the primary predictor of longer hospital stays for gallstone disease.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Surgical Outcomes Research
Background:
- Gallstones are a prevalent global health issue.
- Laparoscopic cholecystectomy is the standard treatment for gallstones.
- Predictive factors for day-surgery laparoscopic cholecystectomy require further investigation.
Purpose of the Study:
- To identify clinical factors predicting prolonged hospital stay after elective laparoscopic cholecystectomy.
- To enhance the safety and efficiency of day-surgery cholecystectomy.
Main Methods:
- Retrospective analysis of 985 patients undergoing elective laparoscopic cholecystectomy for gallstone disease.
- Patients categorized into two groups based on length of stay: ≤2 days (Group A) and >2 days (Group B).
- Univariate and logistic regression analyses employed to identify significant predictors of prolonged hospitalization.
Main Results:
- Univariate analysis indicated age, sex, obesity, and cardiological/nephrological comorbidities were associated with longer stays.
- Logistic regression identified age as the sole significant predictor of extended hospitalization.
- No surgical complications were statistically significant in extending length of stay; comorbidities were influential.
Conclusions:
- Patient age is a key factor in predicting prolonged hospitalization post-laparoscopic cholecystectomy.
- Comorbidities, rather than surgical complications, significantly influence hospitalization duration.
- This study aids in identifying high-risk patients for extended stays, optimizing day-surgery protocols.
Abstract:
Gallstones are one of the most common morbidities in the world. Laparoscopic cholecystectomy is the gold standard for gallbladder stones' removal. Few studies focus on the existence of predictive factors aimed at facilitating cholecystectomy in a day surgery setting. The aim of this retrospective study was to identify clinical factors that could guide day-surgery laparoscopic cholecystectomy safety. The study included 985 consecutive patients who underwent elective laparoscopic cholecystectomy for gallstone disease between May 2006 and February 2015. Patients were divided into two groups: group A with a length of stay ≤ 2 days (922 patients); group B with a length of stay > 2 days (63 patients). Univariate analysis showed that age, sex and the presence of obesity, cardiological, and nephrological comorbidities had a higher likelihood of a longer hospital stay. The logistic regression model showed that only age was a significant predictor of a longer stay. No complication has reached the statistical significance of extending the length of stay in group B. Conversely, the presence of such comorbidities has influenced the hospitalization. Our results allow the identification of a category of patients at high risk of hospitalization within 1 or 2 days from treatment. Moreover, we reported that there is no complication specifically affecting the length of stay. Our findings support the idea that a prolonged length of stay is not linked to the surgical procedure but to the patient's comorbidities.
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