Case Control Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2017; 9(6): 149-152
Published online Jun 27, 2017. doi: 10.4240/wjgs.v9.i6.149
Utility of routine blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones
Offir Ben-Ishay, Marina Zeltser, Yoram Kluger
Offir Ben-Ishay, Marina Zeltser, Yoram Kluger, Surgical Oncology, Pancreatic and Hepatobiliary Surgery Service, Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa 35254, Israel
Author contributions: Ben-Ishay O contributed to study design, interpretation of data, statistical analysis, and drafting of the manuscript; Zeltser M collected data; Kluger Y critically approved the manuscript.
Institutional review board statement: The study was approved by the Institutionsl Review Board.
Informed consent statement: Due to the retrospective nature of the study it was exempt from obtaining informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Offir Ben-Ishay, MD, Surgical Oncology, Pancreatic and Hepatobiliary Surgery Service, Department of General Surgery, Division of Surgery, Rambam Health Care Campus, 8 Ha’Aliyah street, Haifa 35254, Israel.
Telephone: +972-4-8541730 Fax: +972-4-8542321
Received: October 25, 2016
Peer-review started: October 28, 2016
First decision: December 1, 2016
Revised: March 23, 2017
Accepted: April 23, 2017
Article in press: April 25, 2017
Published online: June 27, 2017

To evaluate the value of blood testing after elective laparoscopic cholecystectomy and its association with procedure related complications.


Charts of all patients undergoing elective laparoscopic cholecystectomy from January 2013 through December 2014 were reviewed retrospectively for demographics, indication for surgery, operative course and outcome. In our institution the decision to perform postoperative blood analysis is left for the discretion of the surgeon, therefore we had the possibility to compare the results of those who had blood analyses results to those who did not. Analysis was performed to identify variables associated with the decision to perform postoperative blood tests. Subsequently a univariate and multivariate analyses was performed comparing the two cohorts. Secondary subgroup analysis was performed to identify factors associated with procedure related complications.


Five hundred and thirty-two elective laparoscopic cholecystectomies for symptomatic gallstones were performed during the study period. Sixty-four percent of the patients (n = 340) had blood tests taken post operatively. Patients that had laboratory tests taken were older (P = 0.006, OR = 1.01), had longer surgery (P < 0.001, OR = 3.22) had more drains placed (P < 0.001, OR = 3.2) and stayed longer in the hospital (P < 0.001, OR = 1.2). A subgroup analysis of the patients who experienced complications revealed longer stay in the hospital (P < 0.001), higher body mass index (BMI) (P = 0.04, OR = 1.08), increased rates of drain placement (P = 0.006, OR = 3.1) and higher conversion rates (P = 0.01, OR = 14.6). Postoperative blood tests withdrawals were not associated with complications (P = 0.44). On Multivariate analysis BMI and drain placement were independently associated with complications.


The current study indicate that routine postoperative blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones does not predict complications and may have an added benefit in diagnosis and management of cases were the surgeon encountered true technical difficulty during surgery.

Keywords: Cholecystectomy, Blood tests, Laparoscopy, Complications, Post-operative, Gallstones, symptomatic

Core tip: Laparoscopic cholecystectomy is the procedure of choice for patients with symptomatic gallstones. Although some patients will need overnight observation many of the younger patients, with low body mass index (BMI), that did not have severe gallbladder infection may be performed under day surgery, in institutions that have the necessary setup. The current study show that postoperative blood analyses does not predict nor correlate with postoperative complications and has no impact on outcome. The only independent predictors of complications on multivariate analysis are BMI and drain placement that was used a surrogate for technical difficulty during surgery. Intuitively length of surgery is thought to be in correlation with technical difficulty. In centers were supervised residents perform high percentage of the operations, length of surgery does not correlate with difficulty or post operative complications and by itself does not seem to indicate need for postoperative blood analyses.