Laparoscopic cholecystectomy - What does affect the outcome? A retrospective multifactorial regression analysis

Background: The association between various factors and the postoperative o utcome has not been thoroughly studied in laparoscopic cholecystectomy (LC) . The aim of this retrospective study was to determine which factors signif icantly affect patients outcome after LC. Methods: The medical and operative records of all consecutive patients who underwent LC at our institution from 1991 to 1996 were reviewed. The effect of age, medical and surgical history, duration of procedure, and setup (ur gent or elective) on the postoperative complication rate and on the length of postoperative hospital stay (LOS) were analyzed using multiple linear re gression and logistic regression analysis. Overall, 601 patients were inclu ded in the study. Results: The factors that significantly prolonged LOS were age(p = 0.0145), acute cholecystitis (p = 0.0006), history of ischemic heart disease (p = 0 .0332), and duration of procedure (p < 0.0001). A significantly higher post operative morbidity rate was noted in patients who had a procedure longer t hen 2 h than in patients whose surgery required less the 2 h (13.6% vs 3.6% , respectively; p < 0.0001). Similarly, higher morbidity was noted in elder ly patients than in younger patients (16% vs 6.1%; p = 0.0005). Other facto rs that significantly increased postoperative morbidity included acute chol ecystitis (p = 0.023), a history of cholangitis (p = 0.018), and diabetes ( p = 0.05). Conclusions: According to this study, advanced age, longer duration of proc edure, and acute cholecystitis significantly increase both the postoperativ e morbidity and the LOS. History of ischemic heart disease significantly in creases LOS, but does not increase morbidity after LC.