How to Predict Postoperative Complications After Early Laparoscopic Cholecystectomy for Acute Cholecystitis: the Chole-Risk Score

Background Early laparoscopic cholecystectomy (ELC) is the gold standard treatment for patients with acute calculous cholecystitis (ACC); however, it is still related to significant postoperative complications. The aim of this study is to identify factors associated with an increased risk of postope...

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Published in:Journal of gastrointestinal surgery 2021-11, Vol.25 (11), p.2814-2822
Main Authors: Di Martino, Marcello, Mora-Guzmán, Ismael, Jodra, Víctor Vaello, Dehesa, Alfonso Sanjuanbenito, García, Dieter Morales, Ruiz, Rubén Caiña, Nisa, Francisca García-Moreno, Moreno, Fernando Mendoza, Batanero, Sara Alonso, Sampedro, José Edecio Quiñones, Cumplido, Paola Lora, Bravo, Altea Arango, Rubio-Perez, Ines, Asensio-Gomez, Luis, Aranda, Fernando Pardo, Farrarons, Sara Sentí, Moreno, Cristina Ruiz, Moreno, Clara Maria Martinez, Lasarte, Aingeru Sarriugarte, Calvo, Mikel Prieto, Aparicio-Sánchez, Daniel, Del Pozo, Eduardo Perea, Pellino, Gianluca, Martin-Perez, Elena
Format: Article
Language:English
Subjects:
Cholecystectomy
Cholecystectomy, Laparoscopic - adverse effects
Cholecystitis, Acute - surgery
Gallbladder diseases
Gastroenterology
Humans
Laparoscopy
Length of Stay
Medicine
Medicine & Public Health
Original Article
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative period
Retrospective Studies
Risk Factors
Surgery
Treatment Outcome
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Summary:Background Early laparoscopic cholecystectomy (ELC) is the gold standard treatment for patients with acute calculous cholecystitis (ACC); however, it is still related to significant postoperative complications. The aim of this study is to identify factors associated with an increased risk of postoperative complications and develop a preoperative score able to predict them. Methods Multicentric retrospective analysis of 1868 patients with ACC submitted to ELC. Included patients were divided into two groups according to the presentation of increased postoperative complications defined as postoperative complications ≥ Clavien-Dindo IIIa, length of stay greater than 10 days and readmissions within 30 days of discharge. Variables that were independently predictive of increased postoperative complications were combined determining the Chole-Risk Score, which was validated through a correlation analysis. Results We included 282 (15.1%) patients with postoperative complications. The multivariate analysis predictors of increased morbidity were previous percutaneous cholecystostomy (OR 2.95, p =0.001), previous abdominal surgery (OR 1.57, p =0.031) and diabetes (OR 1.62, p =0.005); Charlson Comorbidity Index >6 (OR 2.48, p =0.003), increased total bilirubin > 2 mg/dL (OR 1.88, p =0.002), dilated bile duct (OR 1.79, p =0.027), perforated gallbladder (OR 2.62, p
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-021-04956-9