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. 2022 Dec 31;408(1):5.
doi: 10.1007/s00423-022-02731-1.

Predictors of poor outcomes after cholecystectomy in gallstone pancreatitis: NSQIP analysis of 30-day morbidity and mortality

Jessica K Liu  1 , Caitlyn Braschi  1 , Christian de Virgilio  1 , Junko Ozao-Choy  1 , Dennis Y Kim  1 , Ashkan Moazzez  2
Affiliations

Predictors of poor outcomes after cholecystectomy in gallstone pancreatitis: NSQIP analysis of 30-day morbidity and mortality

Jessica K Liu et al. Langenbecks Arch Surg. .

Erratum in

Abstract

Background: Contemporary nationwide outcomes of gallstone pancreatitis (GSP) managed by cholecystectomy at the index hospitalization are limited. This study aims to define the rate of 30-day morbidity and mortality and identify associated perioperative risk factors in patients undergoing cholecystectomy for GSP.

Methods: Patients from the ACS-NSQIP database with GSP without pancreatic necrosis, who underwent cholecystectomy during the index hospitalization from 2017 to 2019 were selected. Factors associated with 30-day morbidity and mortality were analyzed.

Results: Of the 4021 patients identified, 1375 (34.5%) were male, 2891 (71.9%) were White, 3923 (97.6%) underwent laparoscopic surgery, and 52.4 years (SD ± 18.9) was the mean age. There were 155 (3.8%) patients who developed morbidity and 15 (0.37%) who died within 30 days of surgery. In bivariate regression analysis, both 30-day morbidity and mortality were associated with older age, elevated pre-operative BUN, hypertension, chronic obstructive pulmonary disease, congestive heart failure, acute kidney injury, and dyspnea. ASA of I or II and laparoscopic surgery were protective against 30-day morbidity and mortality. In multivariable regression analysis, factors independently associated with increased 30-day morbidity included preoperative SIRS/sepsis [OR: 1.68 (95% CI: 1.01-2.79), p = 0.048], and age [OR: 1.03 (95% CI: 1.01-1.04), p = 0.001]. Factors associated with increased 30-day mortality included tobacco use [OR: 8.62 (95% CI: 2.11-35.19), p = 0.003] and age [OR: 1.10 (95% CI: 1.04-1.17), p = 0.002].

Conclusions: Patients with GSP without pancreatic necrosis can undergo cholecystectomy during the index admission with very low risk of 30-day morbidity or mortality.

Keywords: Acute pancreatitis; Cholecystectomy; Gallstone pancreatitis; Morbidity; Mortality; NSQIP.

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