Background:
Laparoscopic cholecystectomy (LC), a common treatment for symptomatic gallstones, has demonstrated safety in low-risk patients. However, existing data is scarce regarding the safety of LC in high-risk patients and the feasibility of early hospital discharge.
Materials and Methods:
This retrospective study included 2296 patients diagnosed with symptomatic gallstones who underwent LC at a tertiary care center from January 2009 through December 2019. We employed propensity score matching to mitigate bias between groups. Statistical significance was set at P<0.05.
Results:
The median age of the patients was 56 years (range 46–67), with a mean Body Mass Index (BMI) of 25.2±4.3 kg/m2. Patients were classified as: American Society of Anesthesiologists (ASA) I (19.7%), II (68.3%), III (12.0%), and IV (0%). ASA I–II included low surgical risk patients (88%) and ASA III-IV comprised high-risk patients (12%). The LC-related 30-day reoperative rate was 0.2% and the readmission rate was 0.87%. Nine patients (0.4%) sustained major bile duct injuries, resulting in a conversion rate of 2.4%. The postoperative mortality rate was 0.04%, and the mean hospitalization time was 3.5 days. Patients in the high-risk group with a history of acute cholecystitis exhibited greater estimated blood loss, longer operative times, and were significantly more likely to be in the longer-stay group.
Conclusion:
Our findings suggest that LC can be conducted safely on high-risk patients, and early hospital discharge is achievable. However, specific factors, such as a history of acute cholecystitis, may result in prolonged hospitalization owing to increased blood loss and longer operative times.