From Elective to Emergent Cholecystectomy: A Single-Center Experience

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Surgical Outcomes Research

Background:

• Symptomatic cholelithiasis (gallstones) frequently necessitates elective cholecystectomy.
• A subset of patients experience acute cholecystitis requiring emergency surgery during the elective waiting period.
• Risk factors for emergency intervention during this interval are not well-defined.

Purpose of the Study:

• To identify risk factors associated with requiring emergency cholecystectomy during the waiting period for scheduled elective surgery.
• To evaluate the impact of waiting time and patient demographics on the need for emergent intervention.

Main Methods:

• Retrospective observational study of patients scheduled for elective cholecystectomy between 2017 and 2022.
• Analysis of medical records to identify patients who underwent emergency cholecystectomy.
• Comparison of demographics and waiting times between elective and emergency surgery cohorts, including subgroup analysis for wait times >60 days.

Main Results:

• Out of 1086 patients, 48 (4.4%) required emergency cholecystectomy.
• Average wait time was significantly higher for the emergency group (60.3 days) vs. elective (47.3 days).
• Waiting periods >60 days (OR 1.805) and obesity (OR not specified, P=0.0001) were significant predictors of needing emergency surgery.

Conclusions:

• A waiting time exceeding 60 days for elective cholecystectomy is associated with a substantially increased risk of requiring emergent surgery.
• Obesity is a critical risk factor that should be considered when stratifying patients for urgent surgical intervention.
• These findings aid in optimizing surgical scheduling and patient management for cholelithiasis.