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Elective cholecystectomy benchmarks: nationwide registry study
By Kihlstedt Pasquier E, Andersson E, Österberg J and 2 others.
Abstract
Background
Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstone disease. The aim of this study was to establish clinically relevant benchmarks for elective laparoscopic cholecystectomy (ELC) to guide quality initiatives and support improvements in patient outcomes.
Method
The Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography provided data on patients treated with primary ELC for a benign indication between 2015 and 2023. Exclusion criteria were common bile duct stones or stents detected before surgery, suspicion of bile duct obstruction, abnormal or unperformed intraoperative cholangiogram, previous major upper abdominal surgery, concomitant surgical procedures, and robotic surgery. The Achievable Benchmark of Care methodology was used to develop intra- and postoperative benchmarks, with severe postoperative complications (Clavien-Dindo ≥ III) representing the primary outcome. During surgery, serious adverse events were defined as intestinal perforation, bile leakage, or bleeding requiring transfusion or conversion to open surgery. Postoperative outcomes were assessed up to 30 days after surgery. Logistic regression identified risk factors for severe postoperative complications.
