Abstract：
BACKGROUND: Cholelithiasis is the most common hospital diagnosis of the digestive system, and its treatment, if symptomatic, is laparoscopic cholecystectomy. There is a growing need for comprehensive determination of postoperative outcomes and the efficiency of healthcare facilities. The \"textbook outcome\"(TO) indicates the quality of care commonly used in oncological procedures, obtained by adding several postoperative parameters, which informs whether a perfect result has been obtained. The main objective of this study is to determine the TO for cholecystectomy and to see the factors that influence its achievement.
METHODS: Retrospective observational unicentric cohort study on patients who underwent cholecystectomy between 2018-2020. We defined TO as those patients who met the following premises: Clavien-Dindo complications < III, postsurgical stay less than the 75th percentile (<3 days), and no readmissions or mortality in the first ninety days. Perioperative characteristics were analyzed, and the patients were divided into two groups according to whether or not they achieved TO. We defined criteria for difficult cholecystectomy according to the operative report.
RESULTS: The percentage of TO was 72% (342/475) (82.6% in elective surgery and 60.5% in urgent surgery). The univariate analysis showed that the following factors are associated with achieving TO: female sex, age <63 years, ASA risk < III, elective surgery, laparoscopic approach, and not difficult cholecystectomy. After multivariate analysis ASA < III (OR 2.39 CI95% 1.37-4.16), elective surgery (OR 2.77 CI95% 1.64-4.67), laparoscopic approach (OR 5.71 CI95% 2.89-11.30) and not to be difficult cholecystectomy (OR 0.42 CI95% 0.259-0.71) remained statistically significant.
CONCLUSIONS: The TO is a healthcare quality tool that is simple to perform, easily interpretable, and helpful for evaluating quality in healthcare and comparing centers. It applies not only to oncological procedures but also to cholecystectomy.
METHODS: Retrospective observational unicentric cohort study on patients who underwent cholecystectomy between 2018-2020. We defined TO as those patients who met the following premises: Clavien-Dindo complications < III, postsurgical stay less than the 75th percentile (<3 days), and no readmissions or mortality in the first ninety days. Perioperative characteristics were analyzed, and the patients were divided into two groups according to whether or not they achieved TO. We defined criteria for difficult cholecystectomy according to the operative report.
RESULTS: The percentage of TO was 72% (342/475) (82.6% in elective surgery and 60.5% in urgent surgery). The univariate analysis showed that the following factors are associated with achieving TO: female sex, age <63 years, ASA risk < III, elective surgery, laparoscopic approach, and not difficult cholecystectomy. After multivariate analysis ASA < III (OR 2.39 CI95% 1.37-4.16), elective surgery (OR 2.77 CI95% 1.64-4.67), laparoscopic approach (OR 5.71 CI95% 2.89-11.30) and not to be difficult cholecystectomy (OR 0.42 CI95% 0.259-0.71) remained statistically significant.
CONCLUSIONS: The TO is a healthcare quality tool that is simple to perform, easily interpretable, and helpful for evaluating quality in healthcare and comparing centers. It applies not only to oncological procedures but also to cholecystectomy.
摘要：
背景：胆结石是消化系统最常见的医院诊断，和它的治疗,如果有症状，是腹腔镜胆囊切除术.越来越需要全面确定术后结果和医疗机构的效率。“教科书结果”(TO)表示肿瘤手术中常用的护理质量，通过添加几个术后参数获得，它告知是否获得了完美的结果。这项研究的主要目的是确定胆囊切除术的TO，并了解影响其成就的因素。
方法：对2018-2020年间接受胆囊切除术的患者进行回顾性观察性单心队列研究。我们将TO定义为符合以下前提的患者：Clavien-Dindo并发症结果：TO的百分比为72％（342/475）（择期手术为82.6％，紧急手术为60.5％）。单因素分析表明，以下因素与实现TO相关：女性，年龄<63岁，ASA风险结论：TO是一种易于执行的医疗保健质量工具，易于解释，并有助于评估医疗保健和比较中心的质量。它不仅适用于肿瘤手术，也适用于胆囊切除术。
方法：对2018-2020年间接受胆囊切除术的患者进行回顾性观察性单心队列研究。我们将TO定义为符合以下前提的患者：Clavien-Dindo并发症
