Are We Overtesting? Rethinking Routine Blood Work After Low-Risk Laparoscopic Cholecystectomy: A Retrospective Study

<i>Background and Objectives</i>: Laparoscopic cholecystectomy is one of the most performed surgical procedures worldwide. In low-risk patients, routine postoperative blood tests are frequently ordered despite limited evidence supporting their necessity. The aim of the study was to evaluate the predictability of complications that may occur with routine postoperative blood tests. <i>Materials and Methods</i>: This retrospective study examined 538 patients who underwent surgery in Cam and Sakura City Hospital between May 2020 and May 2021. Patients were divided into two groups: no postoperative complications (Group NC, n = 521) and postoperative complications (Group C, n = 17). Demographic characteristics, including age and gender, duration of surgery, cystic duct closure method, drain use, complications, preoperative and postoperative blood tests, and the mean time of hospital stay, were the collected data throughout the study. <i>Results</i>: The analysis of the post-operative blood test values revealed that the total bilirubin (<i>p</i> = 0.005), ALT (<i>p</i> = 0.002), AST (<i>p</i> = 0.002), GGT (<i>p</i> = 0.02) and amylase (<i>p</i> = 0.034) values were statistically significantly higher in Group C than in Group NC, but these values did not exceed the normal range except for ALT, AST and GGT, which were slightly higher than the normal parameters. Seventeen patients (3.15%) developed postoperative complications, including biliary leakage (n = 1); choledocholithiasis (n = 2); cardiac (n = 2), pulmonary (n = 9), and hemorrhagic (n = 2) complications; and a superficial wound infection (n = 1). Most complications were identified by symptoms and clinical observation. <i>Conclusions</i>: Routine postoperative blood tests in low-risk laparoscopic cholecystectomy patients do not significantly contribute to the early detection of complications. Clinical observation and targeted use of laboratory or imaging tests in selected high-risk cases might be more efficient. This approach can help reduce unnecessary workload, hospital costs, and healthcare expenditures without compromising patient safety.

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Journal
Medicina
Published
2025-08-29
DOI
https://doi.org/10.3390/medicina61091555
Primary Topic
Gallbladder and Bile Duct Disorders
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article
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article

Are We Overtesting? Rethinking Routine Blood Work After Low-Risk Laparoscopic Cholecystectomy: A Retrospective Study

İdris Kurtuluş, Baki Ekçı, Murat Demir, Hüseyin Kılavuz et al.
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Medicina
Gallbladder and Bile Duct Disorders
article

Are We Overtesting? Rethinking Routine Blood Work After Low-Risk Laparoscopic Cholecystectomy: A Retrospective Study

İdris Kurtuluş, Baki Ekçı, Murat Demir, Hüseyin Kılavuz, Feyyaz Güngör, Sibel Yaman
article en

Abstract

<i>Background and Objectives</i>: Laparoscopic cholecystectomy is one of the most performed surgical procedures worldwide. In low-risk patients, routine postoperative blood tests are frequently ordered despite limited evidence supporting their necessity. The aim of the study was to evaluate the predictability of complications that may occur with routine postoperative blood tests. <i>Materials and Methods</i>: This retrospective study examined 538 patients who underwent surgery in Cam and Sakura City Hospital between May 2020 and May 2021. Patients were divided into two groups: no postoperative complications (Group NC, n = 521) and postoperative complications (Group C, n = 17). Demographic characteristics, including age and gender, duration of surgery, cystic duct closure method, drain use, complications, preoperative and postoperative blood tests, and the mean time of hospital stay, were the collected data throughout the study. <i>Results</i>: The analysis of the post-operative blood test values revealed that the total bilirubin (<i>p</i> = 0.005), ALT (<i>p</i> = 0.002), AST (<i>p</i> = 0.002), GGT (<i>p</i> = 0.02) and amylase (<i>p</i> = 0.034) values were statistically significantly higher in Group C than in Group NC, but these values did not exceed the normal range except for ALT, AST and GGT, which were slightly higher than the normal parameters. Seventeen patients (3.15%) developed postoperative complications, including biliary leakage (n = 1); choledocholithiasis (n = 2); cardiac (n = 2), pulmonary (n = 9), and hemorrhagic (n = 2) complications; and a superficial wound infection (n = 1). Most complications were identified by symptoms and clinical observation. <i>Conclusions</i>: Routine postoperative blood tests in low-risk laparoscopic cholecystectomy patients do not significantly contribute to the early detection of complications. Clinical observation and targeted use of laboratory or imaging tests in selected high-risk cases might be more efficient. This approach can help reduce unnecessary workload, hospital costs, and healthcare expenditures without compromising patient safety.

MedicinaVol. 61(9)
Istanbul Metropolitan Municipality (TR), Sağlık Bilimleri Üniversitesi (TR)
Openalex Percentile: Top 67%
Gallbladder and Bile Duct Disorders
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