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. [AMBROSE Collaborative]

30-day Morbidity and Mortality After Cholecystectomy for Benign Gallbladder Disease (AMBROSE) A Prospective, International Collaborative Cohort Study / G.Y.M. Wong, H. Wadhawan, V. Roth Cardoso, L. Bravo Merodio, Y. Rajeev, R.D. Maldonado, A. Martinino, V. Balasubaramaniam, A. Ashraf, A. Siddiqui, A.G. Al-Shkirat, A. Mohammed Abu-Elfatth, A. Gupta, A. Alkaseek, A. Ouyahia, A. Said, A. Pandey, A. Kumar, B. Maqbool, C.A. Millan, C. Singh, D.A. Pantoja Pachajoa, D.M. Adamovich, E. Petracchi, F. Ashraf, M. Clementi, F. Mulita, G.A. Marom, G. Abdulaal, G.-. Verras, G. Calini, G. Moretto, H. Elfeki, H. Liang, H. Jalaawiy, I. Elzayat, J.K. Das, J.M. Aceves-Ayala, K.T. Ahmed, L. Degrate, M. Aggarwal, M.A. Omar, M. Rais, M. Elhadi, N. Sakran, R. Bhojwani, R. Agarwalla, S. Kanaan, S. Erdene, S. Chooklin, S. Khuroo, S. Dawani, S.T. Asghar, T.K.J. Fung, T. Omarov, V.T. Grigorean, Z. Boras, G.V. Gkoutos, R. Singhal, K. Mahawar, B. Madhok, Y. Graham, C. Donohoe, M. Reira, Y.K.S. Vish, R. Jain, S. Popat, A. Boddy, V. Jain, C.N. Marques, I. Wazir, J.P.S. Pereira, M. Abouelazayem, N. Viswanath, V. Sarodaya, V. Bala, R. Homayoon, A. Dogjani, A. Tidjane, L. Antozzi, J. Hong, A.K. Dash, A. Chokshi, C.R. Wietzycoski, P. Petkov, J.C. Mbonicura, W. Yang, M. Zuluaga, D. Kraljik, E.P. Lincango Naranjo, H.M. Elghadban, A. Diaz, I. Gerogiannis, A. Mohammed, L. Lazaros, A.G. Bhasker, M. Kermansaravi, A.S. Mahdi, M.Y. Kayyal, F. Frattini, N.B. Alabdallah, K.R. Sylvester, I. Abdelhamid, M.H. El Fawal, A.N. Allawgalli, A. Dulskas, K. Voon, C. Caruana, G.P. De Leon Ballesteros, M. Ouadii, P.A. Nashidengo, E. Hazebroek, A. Gunawardene, A. Adeyeye, A.H. Shariff, N.J. Liakopulos, C.J. Toro-Huamanchumo, M. Waledziak, N. Borges, A. Shabbir, I. Negoi, A. Neimark, A. Abouleid, G. Kim, J.A. Kosir, E. Ruiz Ucar, H.K.S. Hamid, R. Masri, M. Ozmen, S. Taha, E. Goodman, H. Al-Naggar, A.K. Ghouali, B. Wafa, S. Allel, B.M. Elkacem, R. Ibagherache, E.H. Seddik, A.T. Kouicem, M. Abdoun, S. Bouaoud, K. Boucenak, S. Khalfa, B. Brahim, B. Tabeti, S.-.-. Meharzi, H. Larbi, R. Derdous, B. Abderaouf, N. Bouregba, F. Boukaaabeche, K. Djeroua, N.A. Sabrin, L. Khennaf, S.N. Mesli, A. Aissat, F.A. Alvarez, N.B. Milagros, V.C. Medrano Ortiz Palombarini, M. Quesada, C. Canullan, J. Varela, H. Posada, C. Du Plessis, J.I. Valenzuela, M.A.F. Zurita, S. Nasim, T.A. Bowles, E. Yeboah, R. Nair, D.M. Felsenreich, N. Allahverdiyeva, R. Abizade, T.A. Barreiro, H.A.D.V. Cunha, M.V. Castilho, R.M.A. Ferreira, R. Legati Junior, L. Dias, C. Wietzycoski, E.W. Jacobi, A. Julianov, A. Saroglu, S. Yuruk, R. Dimov, V. Ivanov, D. Dardanov, Z. Wei, C.A. Millan, M. Urbina, J. Cubieros, S. Acosta, J. Jimenez, I. Vlahovic, N. Koronakis, R.A.B. Gonzalez, C.A.L. Ojeda, C.G. Aspiazu-Briones, D.J. Martinez-Espinoza, E.A. Rivas-Torres, L. Aldabash, I. Shaat, M.M.A. Alsayed, E. Bali, M.A.M. Ayoub, M. Mohamed, M. Al Sayed, A.M.G. Elshinnawy, M. Tayiawi, A.E. Mohamed, A.A.M. Hassan, M.E.-.M. Madany, M. El-Kassas, W. Omar, A. Tawheed, M. Shalaby, A. Sakr, A.E. Elghrieb, H.H. Warda, M. Sadek, M. Mostafa, H. Elghadban, S. Awad, A.M. Maghraby, A.-.-.A. Saleem, A.G. Mahmoud, M. Gebril, A.M. Safy, A. Saada, A. Mohamed Ads, E. Gutierrez, H. Salinas, P. Zimmermann, R. Rhaiem, R. Kianmanesh, E. Efthymiou, S. Konstantinidis, M. Drogouti, A. Katsourakis, M. Papadoliopoulou, N.V. Michalopoulos, T.A. Sidiropoulos, P. Kokoropoulos, A. Ioannidis, M. Konstantinidis, V. Charalampakis, M. Sotiropoulou, A.G. Pantelis, S. Kapiris, I. Tsiampas, V. Tseliou, A. Paspala, C. Nastos, O. Ioannidis, S. Symeonidis, E. Anestiadou, K. Zapsalis, N. Machairas, M.D. Keramida, P. Dorovinis, S. Kyakalos, F. Stavratis, A. Papadopoulos, E. Manioti, O. Mouzakis, V. Nikolaou, E. Barkolias, M. Vasileios, A. Triantafyllou, T. Triantafyllou, G. Matthaiou, M. Frountzas, K.G. Toutouzas, E.C. Tampaki, O. Bellou, C. Papazacharias, D. Moris, E. Felekouras, K. Stamou, G. Tsiotos, D. Fanidou, P.A. Drakos, D. Schizas, A. Syllaios, M. Vailas, D. Georgiadou, N. Zampitis, A. Marinis, F. Stefou, N. Melachroinopoulos, D. Papaconstantinou, D. Dellaportas, P. Lykoudis, K. Lasithiotakis, D. Magouliotis, D. Zacharoulis, A. Laliotis, I. Gkionis, A. Baksi, M. Lodha, S. Kaur, S.S. Guha, A. Gupta, D. Rajput, O. Sharma, F. Huda, M. Hassan, S.K. Singh, S. Basu, N. Kumar, D. Mallik, L.E. David, A. Agrawal, V.G. Pillai, M. Muralee, P.D. Haque, S.K. Veetil, A. Mahajan, D. Jain, D.R. Annareddy, A. Bahadur, S.D. Bisht, M. Kashmira, A. Shukla, H. Sarda, A. Sharma, Paras, R. Alagarsamy, G. Chokkalingam, B.S. Bhalla, M.N. Ahamad, N. Ahmad, A.N. Oommen, S. Subbarayan, K. Mohan, K.S. Jaswal, S.S. Minhas, L. Bains, P. Lal, J.K. Das, G.M. Rangad, A. Lepcha, H. Kynjing, M.S. Islam, V. Shangpliang, A. Thota, K. Pinnamraju, S. Surapaneni, R.P. Gurram, M.M. Reddy, K. Inteti, V. Srikanth, V.J. Reddy, C. Parikh, S. Shah, P. Chaudhary, P. Gupt, A. Srimal, A. Sharma, N. Tayal, G. Ramu, R. Paul, A. Wani, R. Gusani, R. Gupta, A. Khanduri, A. Singh, S. Singh, P. Pokharia, A. Sharma, S.K. Venkatappa, V. Soni, B. Suprapto, A. Tobroni, A. Mousavimaleki, F. Eghbali, F. Eghbali, N. Mashkouri, A. Jasim, N. Kadhim, B. Haj, A. Asadi, G.S. Szydlo, J.A. Demma, A.J. Pikarasy, S. Targa, G. Buzzi, A. Sanna, G. Curro, M. Ammendola, G. Palomba, G. Aprea, M. Capuano, R. Basile, G. Argenio, M. Annecchiarico, D. Ferraro, C. Cacciatore, G. Vennarecci, S. Granieri, A. Bonomi, A. Frontali, C. Cotsoglou, D. Centonze, A. Licciardello, G. Martines, G. Tomasicchio, M. Veroux, R. Gioco, C. Distefano, M. Calabro, D. Caputo, V. La Vaccara, R. Cammarata, T. Farolfi, S.K. Adjei Antwi, G. Brisinda, V. Fico, P. Mirco, A. Biondi, R. Persiani, F. Giovinazzo, F. Frongillo, G. Evola, F. Ferrara, M. Altomare, L. Benuzzi, I. Pezzoli, A. Borghi, S. Cimbanassi, G. Dapri, C. Nessi, F. Bianco, F.M.L. Uccelli, L. Vigano, G. Cordaro, G. Dionigi, A. Pino, D. Morezzi, R. Rizzo, G. Convertini, C. Vallicelli, F. Catena, D. Verdi, I. Mondi, C. Da Lio, G. Loss, F. D'Acapito, D. Di Pietrantonio, F. Tauceri, G. Ercolani, V. Bottino, A. Bosco, A. Canfora, S. Chiappetta, A. Rizzi, M. Breda, F. Quaglino, F. Festa, F.M.C. Savasta, A. Fiore, S. Soncini, A. Giordano, G. Carganico, L. Cocchi, L. Epis, A. Casaril, M. Inama, I. Harmony, C. Michail, V. Alessandro, M. Piazza, G. Basile, E. Pinotti, P. Lapolla, A. Mingoli, G. Brachini, B. Cirillo, M. Campanelli, P. Gentileschi, S. Rossi, B. Picardi, E. Savia, S. Olmi, M. Uccelli, A. Balla, P. Lepiane, F. Saraceno, A. Coppola, F. Paniccia, A. Grasso, N. Tartaglia, G. Pavone, A. Ambrosi, R. Angelico, T.M. Manzia, M. Materazzo, G. Tisone, V. Bresadola, V. Morinelli, P. Matucci-Cerinic, L. Michelutti, A.-. Luzzi, E. Romairone, S. Carrabetta, S. Marzorati, A. Khamees, A.M. Mohammad, S. Alananzeh, S. Al Momani, N. Hijazin, S.A. Tarawneh, H. Alheji, A. Alhajji, M.N. Alzoubi, A.R.A. Al Manasra, R. Elayyan, H. Jamous, M. Dardour, M.R. Mahafdah, A.A. Al Hammoud, M. Al Quran, F. Bosire, R.M. Zakaria, H.R. Abdullah, A. Tarboush, W.A. Hasan, A.A. Kredan, D. Zreeg, A. Muftah, A. Koshlaf, D. Albadi, H.O. Abunaaja, R. Otman, B. Ben Hamida, M.G. Amnaina, H.F. Alhaddad, N.M. Shuaip, Y. Buderbala, A.F. Hamad, H. Shames, H.B. Bakeer, L.E. Shalabi, A.S. Alhadi, M.A.A. Ahjaaz, U. Zgheel, Z. Abdulmoula, H. Younis, M.K. Aboubeirah, M.H. Binnawara, J.A. Arebi, A.A. Alboueishi, S. Mohammed Ammar, H. Abdedalmajed Rhuma, M. Alsori Alharari, S.E. Endisha, C.E. Ng, Y.W. Lee, Y.Z. Tay, N. Abdul Manan, M.S. Tajul Arifin, A.S. Khairul Anuar, N. Kumar, T.K. Maiyauen, A.D. Zakari, M.A. Fathi, M.I. Izhar, D.A. Awang Dahlan, S. Mokhtar, S. Samsudin, B.S. Jaktaram Singh, M.P. Arumugam, K. Theevashini, S.A. Manap, C.W. Yong, M.N. Mohamed Nabil, J.S.H. Lim, S.Y. Cheng, M.M. Amanullah, N. Ahmed, I.V. Lim, M.R. Mazlan, A. Sivananthan, Y. Yussra, S.N. Puvisny, I.B. Chua, M. Sharman, S.L. Siow, J. Axiak, J. Dowling, M. Portelli, J.-. Beristain-Hernandez, O.-. Vazquez-Romero, J. Jaime-Silva, J.-. Cadena-Guzman, J.M. Trevino-Meza, E. Erik, G. Rafael, Maria, J.E. Zuniga, V.M. Pinto Angulo, M. Trejo-Avila, K. Bozada-Gutierrez, C. Carrion, M.N. Gomez-Herrera, A. Garcia-Gomez, S.A. Pimentel Melendez, A.O. Bautista Martinez, S. Nunez De La Rosa, J. Inchaustegui Tinajero, D.E. Sordo Lima, R.H. Perez-Soto, J.D. Hernandez-Acevedo, I. Dominguez-Rosado, M.A. Mercado-Diaz, M. Sierra-Salazar, A. Pimienta, E. Sandag, S. Orgoi, C. Ochir, M. Batmunkh, E.-. Ouazzani, M. El Fdili, K. Hassani Ibn Majdoub, K. Mazaz, M. Errachidy, P. Mekondjo Nashidengo, F. William Quayson, J. Tabiri Abebrese, S. Sushmita Seibes, R. Tjipetekera, Y. Lim, M. Haimona, S.F. Mcclean, S.E.G.R. Rodriguez, A.A.A. Lopez Lopez, E.S. Nwabuoku, U. Mohammed Bello, B. Musa Umar, J.G. Makama, B. Aminu, S.-.N. Oriakhi, A.O. Mosanya, H.E. Omon, F.O. Wuraola, A. Ishola, I. Ulasi, O.O. Irowa, P.I. Agbonrofo, S. Irmiya, A.S. Ammar, S. Khattak, S. Qureshi, N.W. Bashir, H. Jalal, A. Kamran, R. Sultan, M. Fatima, M. Ali, O. Farooq, M.T.J. Khan, U. Soomro, A. Saleem, U.A. Khawaja, R.S. Martins, M.M. Khan, S. Jafferi, T.Q. Faizi, V. Talib, D. Ali, M.H. Javed, M.A. Rasheed, J. Mughal, N. Ijaz, I.U. Rehman, M. Aurangzeb, N. Ahmed, Z.U. Jan, S. Khan, S.S. Aziz, S.G. Shamim Afridi, S.A. Maroof, M.I. Khan, M. Zarin, F. Naz, Z. Jan, S. Ali, S. Azam, H. Jalil, H. Naqvi, T. Siddiqui, G. Murataza, H. Bari, H. Ahmed, M.A. Jayyab, M. Al-Dahdouh, R.R. Echeverria, M.Y. Mendoza, M. Kisielewski, T. Stefura, K. Richter, N. Klos, M. Waledziak, K. Bartosiak, K. Komorowska, M.T. Silvestre, C. Santos, I. Gil, V.S. Cardoso, M.R. Melo, R. Lima, J. Bolota, M. Cotovio, A.R. Stoian, D. Diana Andreea, E.A. Toma, S. Lunca, N. Zarnescu, R.V. Costea, A. Litvin, E. Aljohani, A. Zaid, K. Shaar, K. Awaf, E. Zakarneh, T. Alowayrdi, F. Alyami, A. Alamer, M.Y. Taha, S. Chowdhury, S. Alshahrani, A. Panyko, J. Grosek, A. Tomazic, T. Pintar, E. Castro, D. Sambrano, R. Garcia-Dominguez, C. Tusa, A. Landaluce-Olavarria, B. Estraviz-Mateos, J. Gonzalez, B. Roca, U. Jayarajah, D. Subasinghe, S. Sivaganesh, S. Galal-Eldin, S. Eldirdiri, M. Elnour, N. Asaad, M. Mohammed, L.S. Hassan, K.O. Mohamed, S.A. Abdelrahman, H. Alsadeg, A.A.E. Ali, R.A. Elsiddig Musa, M. Sarih, S. Ismail, O.A.A. Ahmed, S.T.E.H. Taj Eldeen, K.E. Elsiddig, M.E.A.B. Elhasan, M.A.F. Karamelghani, O. Mohammed, A.A. Adam, H.O. Barakat, R.E. Elhadi, A.A. Alnaji, E.H.A.G. Mohamed, H. Al Houri, A. Alhouri, A.K. Soliman, M. Al Ahmad, A.A. Kayali, M. Nasani, Y. Nerabani, E. Ashkar, M.N. Sawas, A.N. Aldirani, A. Zahreddin, A.M. Alasmar, L. Hasan, M.A. Alhosen, M. Klib, A. Rahman Hammadieh, M.T. Chikh Salem, M. Ghandour, S. Sara, N. Kara Tahhan, N. Albani, B. Alsaid, B. Ahmad, M. Almaydaani, M. Abbas, M. Nanaa, M. Aloulou, A. Kudra Danial, A. Khaled, R. Latouf, D. Saeed, A. Ghazal, O. Hamdan, K. Ayoub, L. Kadoura, A.A. Atli, H. Zayat, A. Niazi, A. Dabbit, W. Dahrouj, A. Alhaj, E. Dabbagh, M. Aldaher, A. Bsata, M.Z. Shahrour, M.A. Khusruf, T. Wali, M.T. Aldroubi, M.B. Almoshantaf, M.A. Alahmad, J. Leen, A. Al-Nokta, A. Bakri, A.Y. Arnaout, H. Ibrahim, S. Nastah, O. Rasheed, A. Mohammad, Z. Bokal, B. Gafsi, M. Baccar, H. Ammar, I. Ermis, M. Tokocin, H.A. Kabuli, O. Tokocin, M. Ergenc, T. Gulsen, E. Erginoz, S.S. Uludag, H.O. Bozkir, K. Zengin, M.F. Ozcelik, E. Zarbaliyev, M. Caglikulekci, D. Boler, T.V. Aktokmakyan, C. Peksen, O.A. Savas, A. Sumer, C.E. Guldogan, M. Kaplan, E. Colak, A.N. Sanli, A.I. Kilani, E. Kamer, O. Namdaroglu, F. Ahmed, A. Marzouk, D. Harbinson, H. Abdulrahman, H. Ali, M. Abousamra, F. Di Maggio, A. Abushawaly, M. Badawi, A. Rahman, D. Jenner, K. Ahmed, Y. Watali, F. Soggiu, H. Sheth, P. Drymousis, J. Caterson, S. Mehmood, D. Strachan, L. Mcelroy, M. Chauhan, R. Morgan, M. Mamun, M. Tora, A. Shamali, J. Ml Williamson, N. Slim, S. Mark, L. Huppler, S. Crane, P. Mcgrath, J.T.K. Fung, S.Y. Kok, G. Bond-Smith, A. Dawani, A. Shamardal, M.M.M. Ahmed, C. Obasi, T. Gala, A.M. Elshaer, S. Warner, P. Nathadwarawala, A. Askari, S. Pandanaboyana, R. Thakkar, F. Barbour, J.G. Finch, H. Habib, E. Ansong, J. Attard, A. Aujayeb, M. Fale, A. Gupta, A. Gajdhar, K. Fareed, M.A. Elfeky, M. Ashry, M. Kaur, S. Faycal Mirghani, Y. Tanveer, M. Albendary, P. Bhattacharya, M.A. Ghufran, A. Ghanem, D. Leong, R. Mamidanna, A. Aamery, N. Tewari, G. Williams, H. Tariq, A.K. Klair, K. Jones, H. Selvachandran, A. Day, A. Ajmani, C. Parmar, K. Bosch, R. Young, A. Chan, Y. Silva, A. Kureci, M. Paranyak, O. Shepetko-Dombrovskii, S. Chuklin, Y. Dutka, A.A. Gill, A. Jan, T. Murali, F. Alhajami, N. Atiah, A. Nadeesh, S. Almaqdi. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 281:2(2025 Feb), pp. 312-321. [10.1097/SLA.0000000000006236]

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

S. Cimbanassi
Membro del Collaboration Group
;
2025

Abstract

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. [AMBROSE Collaborative]
benign gallbladder disease; bile duct injury; cholecystectomy; complications; morbidity; mortality;
Settore MEDS-06/A - Chirurgia generale
feb-2025
Article (author)
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