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Does Operative Time Affect Complication Rate in Laparoscopic Cholecystectomy.

David E Wang1, Chetna Bakshi1, Gainosuke Sugiyama1

  • 1Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.

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Summary
This summary is machine-generated.

Increased operative time (OT) during laparoscopic cholecystectomy is linked to higher patient morbidity and longer hospital stays. Further research is needed to understand the factors contributing to longer OT.

Keywords:
acute care surgerybiliarygeneral surgery

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Area of Science:

  • Surgical Outcomes Research
  • Minimally Invasive Surgery
  • Patient Safety

Background:

  • Laparoscopic cholecystectomy is a prevalent surgical procedure in the United States.
  • Understanding factors influencing patient outcomes is crucial for improving surgical care.
  • Operative time (OT) is a potential modifiable factor affecting morbidity.

Purpose of the Study:

  • To investigate the association between increased operative time (OT) and adverse patient outcomes following laparoscopic cholecystectomy.
  • To identify specific morbidities linked to prolonged operative durations.
  • To analyze the impact of OT on length of stay (LOS).

Main Methods:

  • Analysis of adult patients undergoing laparoscopic cholecystectomy for cholecystitis from the ACS NSQIP database (2006-2015).
  • Inclusion criteria: surgery within 3 days of admission, OT between 15 and 360 minutes.
  • Outcome variables included surgical site infections (SSI), dehiscence, pneumonia, sepsis, renal failure, and death.

Main Results:

  • Increased OT (comparing third vs. first quartile) was an independent risk factor for superficial SSI (OR 1.75), organ-space SSI (OR 1.77), dehiscence (OR 2.03), and septic shock (OR 1.81).
  • A significant association was found between longer OT and increased length of stay (LOS), with adjusted incidence rate ratios ranging from 1.16 to 1.53.
  • The study analyzed 7,031 cases, with a median OT of 63 minutes.

Conclusions:

  • Increased operative time is independently associated with higher morbidity rates, including surgical site infections and septic shock.
  • Prolonged operative time directly correlates with an increased length of hospital stay following laparoscopic cholecystectomy.
  • Further prospective studies are recommended to identify factors contributing to extended operative times and their underlying mechanisms.