Table 2.
Clinical outcomes: postoperative complications, long-term follow-up, and survival analysis
| Outcomes | Clavien-Dindo classification grade | Laparoscopic (n = 42) | Open (n = 31) | Laparoscopic converted to open (n = 28) | Total (n = 101) | p-value | Test |
|---|---|---|---|---|---|---|---|
| Postoperative outcomes | |||||||
| Length of hospital stay (day) | - | 1.2 ± 0.4 | 3.6 ± 2.2 | 2.7 ± 1.6 | 2.6 ± 1.9 | < 0.001 | ANOVA |
| Bile leakage | II–IIIa | 0 (0) | 2 (6.5) | 1 (3.6) | 3 (3.0) | 0.043 | Fisher |
| Postoperative hemorrhage | II–IIIb | 1 (2.4) | 3 (9.7) | 1 (3.6) | 5 (5.0) | 0.035 | Fisher |
| Intra-abdominal abscess | IIIa | 1 (2.4) | 3 (9.7) | 1 (3.6) | 5 (5.0) | 0.035 | Fisher |
| Surgical site infection | I–II | 0 (0) | 3 (9.7) | 1 (3.6) | 4 (4.0) | 0.028 | Fisher |
| Bilioma | IIIa | 0 (0) | 2 (6.5) | 1 (3.6) | 3 (3.0) | 0.043 | Fisher |
| Pancreatitis/cholestasis | II | 2 (4.8) | 4 (12.9) | 2 (7.1) | 8 (7.9) | 0.021 | Fisher |
| Reoperation | IIIb | 0 (0) | 3 (9.7) | 1 (3.6) | 4 (4.0) | 0.028 | Fisher |
| Mortality | V | 0 (0) | 1 (3.2) | 0 (0) | 1 (1.0) | 0.115 | Fisher |
| Postoperative ERCP requirement | IIIa | 2 (4.8) | 6 (19.4) | 2 (7.1) | 10 (9.9) | 0.012 | Fisher |
| Overall morbidity (≥ grade II)a) | - | 4 (9.5) | 14 (45.2) | 6 (21.4) | 24 (23.8) | < 0.001 | χ2 |
| Follow-up data | |||||||
| Duration of follow-up (yr) | - | 6.4 ± 3.2 | 7.3 ± 3.5 | 6.9 ± 3.3 | 6.7 ± 3.2 | 0.428 | ANOVA |
| Follow-up completion rateb) | - | 38 (90.5) | 27 (87.1) | 24 (85.7) | 89 (88.1) | 0.782 | χ2 |
| Lost to follow-up | - | 4 (9.5) | 4 (12.9) | 4 (14.3) | 12 (11.9) | - | - |
| Histopathological findings | |||||||
| Chronic cholecystitis | - | 24 (57.1) | 13 (41.9) | 14 (50.0) | 51 (50.5) | < 0.001 | χ2 |
| Xanthogranulomatous cholecystitis | - | 9 (21.4) | 4 (12.9) | 4 (14.3) | 17 (16.8) | 0.548 | χ2 |
| Long-term complications | |||||||
| Biliary stricture | - | 0 (0) | 2 (6.5) | 1 (3.6) | 3 (3.0) | 0.043 | Fisher |
| Incisional hernia | - | 0 (0) | 2 (6.5) | 1 (3.6) | 3 (3.0) | 0.043 | Fisher |
| Stone recurrencec) | - | 0 (0) | 0 (0) | 0 (0) | 0 (0) | NA | - |
| Chronic abdominal pain | - | 3 (7.1) | 5 (16.1) | 3 (10.7) | 11 (10.9) | 0.024 | χ2 |
| Dyspeptic symptoms | - | 2 (4.8) | 3 (9.7) | 2 (7.1) | 7 (6.9) | 0.682 | χ2 |
| Complication-free survival (%)d) | Log-rank p | ||||||
| 1-year CVS rate | - | 97.6 (41/42) | 87.1 (27/31) | 92.9 (26/28) | 93.1 (94/101) | 0.038 | Log-rank |
| 3-year CVS rate | - | 95.2 (40/42) | 80.6 (25/31) | 89.3 (25/28) | 89.1 (90/101) | 0.024 | Log-rank |
| 5-year CVS rate | - | 92.9 (39/42) | 74.2 (23/31) | 85.7 (24/28) | 85.1 (86/101) | 0.018 | Log-rank |
| 10-year CVS rate | - | 90.5 (38/42) | 67.7 (21/31) | 82.1 (23/28) | 81.2 (82/101) | 0.012 | Log-rank |
| Number at riske) | |||||||
| At 1 yr | - | 42 | 31 | 28 | 101 | - | - |
| At 3 yr | - | 40 | 28 | 26 | 94 | - | - |
| At 5 yr | - | 36 | 25 | 23 | 84 | - | - |
| At 10 yr | - | 24 | 18 | 16 | 58 | - | - |
Values are presented as mean ± standard deviation, number (%), or number only.
ERCP, endoscopic retrograde cholangiopancreatography; CVS, critical view of safety; -, not available; NA, not applicable.
a)Unique patients with ≥ 1 complication (individuals may have multiple complications).
b)Active surveillance: clinical exam + ultrasonography at 6, 12, 24 months, then annually.
c)Stone recurrence assessed by ultrasonography; computed tomography, only when clinically indicated.
d)Kaplan-Meier estimates; parentheses: patients free from complications/total enrolled.
e)Patients under active follow-up at each time point after censoring for loss to follow-up, death, or insufficient duration; differs from CFS numerator (all complication-free patients regardless of current follow-up status).