Postoperative Complications of Laparoscopic Cholecystectomy for Acute Cholecystitis: A Comparison to the ACS-NSQIP Risk Calculator and the Tokyo Guidelines.
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.



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



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.



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.
Medical College of Wisconsin, 8701 W Watertown Plank Road, Milwaukee, WI, 53226, USA. Rmassoum@gmail.com.
Roxanne L
RL
Massoumi
Division of Trauma and Critical Care, Medical College of Wisconsin, 8701 W Watertown Plank Road, Milwaukee, WI, 53226, USA.
Colleen M
CM
Trevino
Division of Trauma and Critical Care, Medical College of Wisconsin, 8701 W Watertown Plank Road, Milwaukee, WI, 53226, USA.
Travis P
TP
Webb
D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000601:surgery; D061887:Conversion to Open Surgery; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014481:United States