Elective laparoscopic cholecystectomy: preoperative prediction of duration of surgery.
BACKGROUND
Efficient use of operating time has become a key concern. The aim of this study was to determine preoperative factors that can predict extended duration of operating time (>90 min) for laparoscopic cholecystectomy (LC).


METHODS
Data collected prospectively on 827 consecutive patients who underwent elective LC between 1990 and 1997 were analyzed. Factors evaluated included age, gender; body mass index; comorbidity; duration of symptoms; history of jaundice, pancreatitis, or abdominal surgery; dilated common bile duct or thick-walled gallbladder on ultrasound; preoperative endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES); and surgeon experience. Univariate and multivariate analyses were performed to identify factors predicting a long operation.


RESULTS
Operating time was longer than 90 min in 276 patients (33%). Predictors of extended operation time were age older than 55 years (odds ratio [OR] = 9.7), preoperative ES (OR = 2.8), and a thick-walled gallbladder on ultrasound (OR = 2.5).


CONCLUSIONS
These predictors may be useful in planning theater lists and anesthesia management, and in selecting patients for day surgery.
Ammori
B J
BJ
Leeds Institute for Minimally Invasive Therapy (LIMIT), Wellcome Wing, The General Infirmary, Great George Street, Leeds LS1 3EX, UK.
Larvin
M
M
McMahon
M J
MJ
D000367:Age Factors; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000379:methods / Q000706:statistics & numerical data*; D002769:Cholelithiasis / Q000601:surgery; D005260:Female; D005704:Gallbladder / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011300:Preoperative Care / Q000706:statistics & numerical data; D011336:Probability; D016717:Sphincterotomy, Endoscopic / Q000706:statistics & numerical data; D013997:Time Factors; D014463:Ultrasonography