Korean J Hepatobiliary Pancreat Surg.  2016 Feb;20(1):12-16. 10.14701/kjhbps.2016.20.1.12.

Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy

Affiliations
  • 1Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. kskim88@yuhs.ac
  • 2Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 3Department of Surgery, Incheon St. Mary Hospital, Catholic University College of Medicine, Incheon, Korea.
  • 4Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 5Department of Surgery, Daejeon St. Mary Hospital, Catholic University College of Medicine, Daejeon, Korea.
  • 6Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 7Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 8Department of Surgery, Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Abstract

BACKGROUNDS/AIMS
Laparoscopic cholecystectomy can reduce postoperative pain and recovery time. However, some patients experience prolonged postoperative hospital stay. We aimed to identify factors influencing the postoperative hospital stay after laparoscopic cholecystectomy.
METHODS
Patients (n=336) undergoing laparoscopic cholecystectomy for gallbladder pathology at 8 hospitals were enrolled and divided into 2 groups: 2 or less and more than 2 days postoperative stay. Perioperative factors and patient factors were retrospectively analyzed.
RESULTS
The patient population median age was 52 years, and consisted of 32 emergency and 304 elective operations. A univariate analysis of perioperative factors revealed significant differences in operation time (p<0.001), perioperative transfusion (p=0.006), emergency operation (p<0.001), acute inflammation (p<0.001), and surgical site infection (p=0.041). A univariate analysis of patient factors revealed significant differences in age (p<0.001), gender (p=0.036), diabetes mellitus (p=0.011), preoperative albumin level (p=0.024), smoking (p=0.010), and American Society of Anesthesiologists score (p=0.003). In a multivariate analysis, operation time (p<0.001), emergency operation (p<0.001), age (p=0.014), and smoking (p=0.022) were identified as independent factors influencing length of postoperative hospital stay.
CONCLUSIONS
Operation time, emergency operation, patient age, and smoking influenced the postoperative hospital stay and should be the focus of efforts to reduce hospital stay after laparoscopic cholecystectomy.

Keyword

Laparoscopic cholecystectomy; Hospital stay; Postoperative complications
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