Clinical Outcomes and Predictors of Complications Following Laparoscopic Cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy is the standard treatment for symptomatic gallbladder disease, although postoperative complications remain an important concern, particularly in patients with inflammatory and technically difficult conditions. Aim of the study: This study aimed to evaluate clinical outcomes following laparoscopic cholecystectomy and identify factors independently associated with postoperative complications. Methods: This prospective observational study was conducted among 250 consecutive adults undergoing elective or urgent laparoscopic cholecystectomy at a tertiary-care hospital in Bangladesh over a 2-year period, from (start) to (end). Demographic, clinical, ultrasonographic, operative, and postoperative data were collected, and complications were assessed during the 30-day follow-up and graded using the Clavien-Dindo classification. Multivariable logistic regression was performed to identify independent predictors of postoperative complications, with p<0.05 considered statistically significant. Results: Among 250 patients, the mean age was 46.8 ± 13.7 years, 68.8% were female, and 84.4% underwent elective surgery. Postoperatively, 86.4% had an uncomplicated recovery, while 13.6% developed complications; conversion to open surgery occurred in 3.6%, with no mortality. After adjustment, difficult operative procedures (aOR 3.57; p=0.006), dense adhesions (aOR 3.28; p=0.006), acute cholecystitis (aOR 2.31; p=0.049), and operative duration >60 minutes (aOR 2.14; p=0.047) independently predicted postoperative complications. Conclusion: Overall, laparoscopic cholecystectomy provided favorable short-term outcomes with low complication and conversion rates. Acute cholecystitis, dense adhesions, difficult surgery, and prolonged operative duration independently predicted postoperative complications, highlighting the importance of careful risk assessment and operative planning.