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Gallbladder wall thickness as a predictor of intraoperative events during laparoscopic cholecystectomy: A prospective study of 1089 patients

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  • Nikolaos Kokoroskos
  • Thomas Peponis
  • Jae Moo Lee
  • Majed El Hechi
  • Leon Naar
  • Joana Abed Elahad
  • Charlie Nederpelt
  • Alexander Bonde
  • Karien Meier
  • April Mendoza
  • David King
  • Peter Fagenholz
  • Haytham Kaafarani
  • George Velmahos
  • Noelle Saillant
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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.

Original languageEnglish
JournalAmerican Journal of Surgery
Volume220
Issue number4
Pages (from-to)1031-1037
Number of pages7
ISSN0002-9610
DOIs
Publication statusPublished - 1 Oct 2020

    Research areas

  • Gallbladder wall thickness, Intraoperative events, Laparoscopic cholecystectomy, Predictor of operative complexity

ID: 59609689