30-day Morbidity and Mortality after Cholecystectomy for Benign Gallbladder Disease (AMBROSE): A Prospective, International Collaborative Cohort Study


Wong G. Y. M., Wadhawan H., Roth Cardoso V., Bravo Merodio L., Rajeev Y., Maldonado R. D., ...Daha Fazla

Annals of Surgery, cilt.281, sa.2, ss.312-321, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 281 Sayı: 2
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1097/sla.0000000000006236
  • Dergi Adı: Annals of Surgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, Veterinary Science Database, Nature Index
  • Sayfa Sayıları: ss.312-321
  • Anahtar Kelimeler: benign gallbladder disease, bile duct injury, cholecystectomy, complications, morbidity, mortality
  • Samsun Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to assess 30-day morbidity and mortality rates following cholecystectomy for benign gallbladder disease and identify the factors associated with complications. Background: Although cholecystectomy is common for benign gallbladder disease, there is a gap in the knowledge of the current practice and variations on a global level. Methods: A prospective, international, observational collaborative cohort study of consecutive patients undergoing cholecystectomy for benign gallbladder disease from participating hospitals in 57 countries between January 1 and June 30, 2022, was performed. Univariate and multivariate logistic regression models were used to identify preoperative and operative variables associated with 30-day postoperative outcomes. Results: Data of 21,706 surgical patients from 57 countries were included in the analysis. A total of 10,821 (49.9%), 4263 (19.7%), and 6622 (30.5%) cholecystectomies were performed in the elective, emergency, and delayed settings, respectively. Thirty-day postoperative complications were observed in 1738 patients (8.0%), including mortality in 83 patients (0.4%). Bile leaks (Strasberg grade A) were reported in 278 (1.3%) patients, and severe bile duct injuries (Strasberg grades B-E) were reported in 48 (0.2%) patients. Patient age, American Society of Anesthesiologists physical status class, surgical setting, operative approach, and Nassar operative difficulty grade were identified as the 5 predictors demonstrating the highest relative importance in predicting postoperative complications. Conclusions: This multinational observational collaborative cohort study presents a comprehensive report of the current practices and outcomes of cholecystectomy for benign gallbladder disease. Ongoing global collaborative evaluations and initiatives are needed to promote quality assurance and improvement in cholecystectomy.