Postoperative complication rates in patients undergoing urgent and elective videolaparoscopic cholecystectomy

Abstract

This study analyzed the epidemiological profile and postoperative complications of patients undergoing urgent and elective laparoscopic cholecystectomy at a tertiary public hospital in the Central-Northern region of Goiás. This was a cross-sectional, analytical, and comparative study, with retrospective data collection from medical records of patients aged ≥18 years who underwent surgery between 2023 and 2024. The variables evaluated included demographic characteristics, operative time, self-limited intraoperative bleeding, complications, length of hospital stay, need for ICU admission, and mortality. A total of 524 patients were included, with a predominance of females (79.8%) and a mean age of 50.8 ± 15.3 years. The overall complication rate was low (1.7%), but higher in the urgent group (3.9%) compared to the elective group (1.3%). Operative time was significantly longer in urgent procedures, exceeding 45 minutes in 93.4% of cases, compared to 78.3% in elective surgeries (p < 0.01). In the multivariate analysis, urgent surgery (OR = 7.98; p = 0.014), ICU admission (OR = 6.03; p < 0.001), and self-limited intraoperative bleeding (OR = 5.28; p < 0.001) were independently associated with complications. Prolonged hospital stay (≥3 days) was associated with urgent surgery, ICU admission, operative time >45 minutes, male sex, and complications. In conclusion, laparoscopic cholecystectomy showed a low complication rate. Urgent procedures, intensive care, and self-limited intraoperative bleeding represent markers of greater clinical and technical complexity and are associated with a higher risk of adverse events. These factors, together with male sex and prolonged operative time, were also associated with longer hospital stays.