Abstract
Background: Laparoscopic cholecystectomy is currently the gold standard for the treatment of cholecystitis. Results may have great variability depending on the comorbidities of the patient, the severity of the acute cholecystitis and whether the procedure was elective or urgent. Higher rates of complications and the need for conversion to open surgery have been observed in patients who underwent emergency laparoscopic cholecystectomy with respect to elective surgery. Methods: Retrospective review of the medical records and ACS NSQIP data collected prospectively from all those patients who underwent cholecystectomy using the Current Terminology Codes during January 2015 to December 2015 at Medica Sur Clinic Foundation in Mexico City. Each patient was individually entered into the risk calculator. data presented as frequencies and averages. A bivariate analysis was performed using the student t test. A value of p < 0.05 was considered statistically significant. Results: During the period from Jan 2015 to Dec 2015, 261 were admitted for cholecystectomy. The overall complication rate was 5.7%, there was no mortality during the study period. After applied The ACS NSQIP risk calculator, we found that this risk calculator was a good predictor of the surgical results, except for the days of hospital stay (predicted 0.96 vs real 2.82 days, p < 0.001), surgical site infection (predicted 1.1 vs real 0.4%, p = 0.003), urinary tract infection (predicted 0.2 vs real 0%, p < 0.001), hospital readmission (predicted 3.3 vs real 1.5%, p < 0.03), death (predicted 0.2 vs real 0%, p < 0.001). Conclusion: Risk calculator of the American College of Surgeons is useful predicting postoperative complications, but not predicting days of hospital stay in our population. We obtained lower frecuency of complications of surgical site infections, readmission and urinary tract infections.
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