TY - JOUR
T1 - Gallbladder wall thickness as a predictor of intraoperative events during laparoscopic cholecystectomy
T2 - A prospective study of 1089 patients
AU - Kokoroskos, Nikolaos
AU - Peponis, Thomas
AU - Lee, Jae Moo
AU - El Hechi, Majed
AU - Naar, Leon
AU - Elahad, Joana Abed
AU - Nederpelt, Charlie
AU - Bonde, Alexander
AU - Meier, Karien
AU - Mendoza, April
AU - King, David
AU - Fagenholz, Peter
AU - Kaafarani, Haytham
AU - Velmahos, George
AU - Saillant, Noelle
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - BACKGROUND: Laparoscopic cholecystectomy (LC) has a wide range of technical difficulty. Preoperative risk stratification is essential for adequate planning and patient counseling. We hypothesized that gallbladder wall thickness (GWT) is more objective marker than symptom duration in predicting complexity, as determined by operative time (OT), intraoperative events (IE), and postoperative complications.METHODS: All adult patients who underwent LC during 2010-2018 were included. GWT, measured on imaging and on the histopathologic exam, was divided into three groups: <3 mm (normal), 3-7 mm and >7 mm. Univariate and multivariable analyses were performed to determine the association between GWT and 1) operative time, 2) the incidence of IE and 3) postoperative outcomes.RESULTS: A total of 1089 patients, subjects to LC, were included in the study. GWT was positively correlated with median OT (p < 0.001), the incidence of IE (p < 0.001) and median length of hospital stay (p < 0.001). GWT independently predicted IE (OR = 2.1 95% CI: 1.3-3.4) and outperformed symptom duration, which was not significantly associated with any of the outcomes (p = 0.7).CONCLUSIONS: GWT independently predicted IE and may serve as an objective marker of LC complexity.
AB - BACKGROUND: Laparoscopic cholecystectomy (LC) has a wide range of technical difficulty. Preoperative risk stratification is essential for adequate planning and patient counseling. We hypothesized that gallbladder wall thickness (GWT) is more objective marker than symptom duration in predicting complexity, as determined by operative time (OT), intraoperative events (IE), and postoperative complications.METHODS: All adult patients who underwent LC during 2010-2018 were included. GWT, measured on imaging and on the histopathologic exam, was divided into three groups: <3 mm (normal), 3-7 mm and >7 mm. Univariate and multivariable analyses were performed to determine the association between GWT and 1) operative time, 2) the incidence of IE and 3) postoperative outcomes.RESULTS: A total of 1089 patients, subjects to LC, were included in the study. GWT was positively correlated with median OT (p < 0.001), the incidence of IE (p < 0.001) and median length of hospital stay (p < 0.001). GWT independently predicted IE (OR = 2.1 95% CI: 1.3-3.4) and outperformed symptom duration, which was not significantly associated with any of the outcomes (p = 0.7).CONCLUSIONS: GWT independently predicted IE and may serve as an objective marker of LC complexity.
KW - Gallbladder wall thickness
KW - Intraoperative events
KW - Laparoscopic cholecystectomy
KW - Predictor of operative complexity
UR - http://www.scopus.com/inward/record.url?scp=85081671477&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2020.03.007
DO - 10.1016/j.amjsurg.2020.03.007
M3 - Journal article
C2 - 32178838
VL - 220
SP - 1031
EP - 1037
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 4
ER -