PhD Scientific Days 2024

Poster Session O - Surgical Medicine

Cross sectional single center study to assess technical quality and short term outcomes of cholecystectomy

Text of the abstract

Cholecystectomy is one of the most frequently performed operations worldwide. The preferred technique is laparoscopy. This necessitates a thorough knowledge of anatomy and the correct application of surgical techniques. Even experienced surgeons may face challenges and may need to modify the surgical plan or convert to open surgery in difficult situations.

In this study, we examined cholecystectomies performed over eight consecutive weeks in 2023 at our institution. We focused on the technical aspects and the short-term outcomes of the surgeries. Data collection was conducted as part of the Global Surg 4 GECKO international study.

During the study period, we performed 49 surgeries. The average age of the patients was 52.7 years, with a standard deviation of 14.7 years. We operated on 15 men and 34 women. According to ASA classification, there were 9, 25, and 15 patients in grades 1, 2, and 3, respectively. We performed 32 elective, 8 delayed, and 9 emergency surgeries. In 44 cases, the surgeries were laparoscopic, 2 were open, and 3 were converted. The reason for open surgeries were severe inflammation in both cases. One of the converted cases was due to chronic cholecystitis, and the other two were due to acute cholecystitis. Conversions occurred due to uncertain anatomy in 2 cases and suspicion of bile duct injury in 1 case. During one open surgery, a subtotal, in all other cases, a total cholecystectomy was performed. The gallbladder wall was opened in 11 cases, of which 2 were delayed, 5 were acute, and 4 were elective. There were 3 cases of intraoperative bleeding. No bile duct injuries occurred. On average, patients spent 3.9 days in the hospital. There was no morbidity or mortality of Clavien-Dindo grade 3 or higher within the first 30 postoperative days.

Our institution's cross-sectional study highlights that cholecystectomy is a safely performable procedure. However, acute or chronic inflammation can complicate the technical execution of the surgery and pose a risk of complications. Laparoscopic cholecystectomy is the first-choice procedure, but open surgery may be selected depending on the severity of the disease. The surgical plan may be altered during the procedure, and conversion may occur in difficult cholecystectomy cases. With the correct technique, the risk of cholecystectomy can be maintained at a low level even in difficult situations.