Factors Affecting the Duration of Laparoscopic Cholecystectomy at Buayai Hospital

Abstract

            Laparoscopic cholecystectomy (LC) is the gold standard treatment for gallstone disease; however, prolonged operative time increases the risk of complications and hospital resource burden. This study aimed to identify clinical factors associated with operative duration and evaluate postoperative outcomes at Buayai Hospital. A retrospective study was conducted among 40 patients who underwent LC between August 2024 and August 2025. Data were analyzed using descriptive statistics, univariable and multivariable linear regression, Poisson regression with robust standard errors, and Mann-Whitney U test.

            The mean age was 53.9 ± 15.7 years (62.5% female), with a median operative time of 59 minutes. Multivariable linear regression identified gangrenous cholecystitis as the strongest predictor, increasing operative time by 73.20 minutes (95%CI: 24.97, 121.43), while each 1 kg/m² increase in BMI added 3 minutes (p = 0.017) (Adj R² = 0.379). Multivariable Poisson regression showed that gangrenous cholecystitis increased the risk of prolonged surgery (≥ 60 minutes) 2.24-fold (p < 0.001), and each 1 cm increase in gallbladder diameter increased the risk 1.37-fold (p < 0.001). The prolonged operative time group had significantly higher estimated blood loss (p = 0.002).

            Gangrenous cholecystitis, elevated BMI, and larger gallbladder dimensions are significant predictors of prolonged operative time and are directly associated with greater blood loss. These findings support preoperative risk stratification using ultrasound findings and BMI to optimize operating room planning. Further prospective or multicenter studies are warranted to validate these results.