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Surgeon’s Volume Is Not Associated with Complication Outcome After Laparoscopic Cholecystectomy

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Abstract

Aim

Complication rates after laparoscopic cholecystectomy vary but are still reported to be up to 17 %. Identifying risk factors for an adverse complication outcome could help to reduce morbidity after laparoscopic cholecystectomy. Our aim was to analyze whether surgeon volume is a vital issue for complication outcome.

Methods

All complications—minor, major, local and general—were reviewed in a single institution between January 2004 and December 2008 and recorded in a database. Patient’s variables, disease related variables and surgeon’s variables were noted. The role of surgeon’s individual volume per year was analyzed. A stepwise logistic regression model was used.

Results

A total of 942 patients were analyzed, among which 70 (7 %) patients with acute cholecystitis and 52 (6 %) patients with delayed surgery for acute cholecystitis. Preoperative endoscopic retrograde cholangiography (ERC) had been performed in 142 (15 %) patients. Complication rates did not differ significantly for surgeon’s individual volume (≤10 vs. >10 LC/year, 5.2 vs. 8.2 %, p = 0.203) nor for specialization (laparoscopic vs. non-laparoscopic; 9.2 vs. 6.4 %, p = 0.085) and experience (specialty registration ≤5 vs. >5 years; 5.1 vs. 8.7 %, p = 0.069). The only significant predictors for complications were acute surgery (OR 3.9, 95 % CI 1.8–8.7, p = 0.001) and a history preceding laparoscopic cholecystectomy (LC) (ERC and delayed surgery for cholecystitis) (OR 8.1, 95 % CI 4.5–14.6: p <0.001).

Conclusion

Complications after LC were not significantly associated with a surgeon’s individual volume, but most prominently determined by the type of biliary disease.

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Authors and Affiliations

  1. Department of Surgery, Onze Lieve Vrouwe Gasthuis (OLVG), Postbus 95500, 1090 HM, Amsterdam, The Netherlands

    Sandra C. Donkervoort, Pieter G. Versluis, Emile A. Clous & Anco C. Vahl

  2. Teaching Hospital, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands

    Lea M. Dijksman

Authors
  1. Sandra C. Donkervoort
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  2. Lea M. Dijksman
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  3. Pieter G. Versluis
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  4. Emile A. Clous
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  5. Anco C. Vahl
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Correspondence to Sandra C. Donkervoort.

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Donkervoort, S.C., Dijksman, L.M., Versluis, P.G. et al. Surgeon’s Volume Is Not Associated with Complication Outcome After Laparoscopic Cholecystectomy. Dig Dis Sci 59, 39–45 (2014). https://doi.org/10.1007/s10620-013-2885-5

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  • DOI: https://doi.org/10.1007/s10620-013-2885-5

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