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Postoperative Complications of Laparoscopic Cholecystectomy for Acute Cholecystitis: A Comparison to the ACS-NSQIP Risk Calculator and the Tokyo Guidelines. World J Surg 2017 Apr;41(4):935-939

Date

11/12/2016

Pubmed ID

27834012

DOI

10.1007/s00268-016-3816-3

Scopus ID

2-s2.0-84994761833   19 Citations

Abstract

BACKGROUND: We compared observed postoperative outcomes from laparoscopic cholecystectomy performed for acute cholecystitis (AC) to outcomes predicted by the ACS-NSQIP risk calculator.We also noted and compared any differences in observed outcomes across the different Tokyo Guidelines (TG) levels of AC severity.We hypothesized that ACS-NSQIP would accurately predict complications and length of stay (LOS) and that increased TG severity levels would correlate with more complications, increased conversion to open surgery, and longer LOS.

METHODS: A review of all patients who underwent laparoscopic cholecystectomy for acute cholecystitis over eighteen months was performed.

RESULTS: ACS-NSQIP predicted a complication rate of 4.6% (11% found) and LOS of 0.73 days (2.5 found), p < 0.05. Increased TG severity had LOS of 1.89, 2.75, and 5.33, respectively, p < 0.05. The complication numbers and conversion to open cholecystectomy were insignificant between the TG classes.

CONCLUSION: ACS-NSQIP did not accurately predict complications or LOS. TG classifications did not show a significant difference in complications or conversion to open surgery, but positively correlated with LOS. ACS-NSQIP may not accurately predict patient outcomes and the TG, originally created with the purpose of differentiating levels of inflammation and severity, may only be useful for predicting LOS.

Author List

Massoumi RL, Trevino CM, Webb TP

Authors

Colleen Trevino PhD Assistant Professor in the Surgery department at Medical College of Wisconsin
Travis P. Webb MD, MHPE Associate Dean, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cholecystectomy, Laparoscopic
Cholecystitis, Acute
Conversion to Open Surgery
Humans
Length of Stay
Postoperative Complications
Retrospective Studies
Risk Assessment
Severity of Illness Index
United States