TY - JOUR
T1 - Impact of patient factors on operative duration during laparoscopic cholecystectomy
T2 - evaluation from the National Surgical Quality Improvement Program database
AU - Lowndes, Bethany
AU - Thiels, Cornelius A.
AU - Habermann, Elizabeth B.
AU - Bingener, Juliane
AU - Hallbeck, Susan
AU - Yu, Denny
N1 - Funding Information:
This article was supported by The National Institute of Diabetes and Digestive and Kidney Diseases ( K23 DK 93553 ) and Mayo Clinic's Department of Surgery Research . Also, this publication was made possible by funding from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.
Publisher Copyright:
© 2016 The Authors
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration. Methods The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all elective LC for biliary colic from 2005 to 2013. Multivariate general linear model and logistic regression were used to evaluate patient factors as predictors of operative duration greater than 60 minutes, adjusted for resident involvement and cholangiography. Results A total of 24,099 LC met inclusion criteria. Regression analysis found procedure duration greater than 60 minutes was less likely for patients age greater than 40 and less than 30 (P <.001) and more likely for men (P <.05), body mass index (BMI) greater than 30 compared with BMI 18.5 to 24.9 (P <.05), abnormal liver function test (LFT) (P <.05), and higher ASA class (P < .05). Smoking, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and abnormal white blood cell count were not significant predictors. Conclusions Higher BMI, younger age, male gender, higher ASA, and abnormal LFTs are possible predictors of prolonged LC duration and can aid in operating room scheduling and utilization.
AB - Background Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration. Methods The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all elective LC for biliary colic from 2005 to 2013. Multivariate general linear model and logistic regression were used to evaluate patient factors as predictors of operative duration greater than 60 minutes, adjusted for resident involvement and cholangiography. Results A total of 24,099 LC met inclusion criteria. Regression analysis found procedure duration greater than 60 minutes was less likely for patients age greater than 40 and less than 30 (P <.001) and more likely for men (P <.05), body mass index (BMI) greater than 30 compared with BMI 18.5 to 24.9 (P <.05), abnormal liver function test (LFT) (P <.05), and higher ASA class (P < .05). Smoking, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and abnormal white blood cell count were not significant predictors. Conclusions Higher BMI, younger age, male gender, higher ASA, and abnormal LFTs are possible predictors of prolonged LC duration and can aid in operating room scheduling and utilization.
KW - Laparoscopic cholecystectomy
KW - NSQIP
KW - Patient factors
KW - Procedural difficulty
KW - Procedure duration
KW - Science of health care delivery
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U2 - 10.1016/j.amjsurg.2016.01.024
DO - 10.1016/j.amjsurg.2016.01.024
M3 - Article
C2 - 27174790
AN - SCOPUS:84965136053
SN - 0002-9610
VL - 212
SP - 289
EP - 296
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 2
ER -