388 Impact of Surgeon Case Volume on Cholecystectomy Outcomes: A Retrospective Cohort Study

Abstract Aim Higher surgeon case volumes are often associated with improved patient outcomes, particularly in complex or high-risk procedures. While laparoscopic cholecystectomy (LC) is a commonly performed operation, variability in outcomes persists. This study aimed to evaluate whether individual surgeon case volume influences clinical outcomes in LC. Method This multicentre retrospective cohort study included consecutive adult patients who underwent elective or emergency LC across three hospitals within a single health board between August 2023 and July 2024. Surgeons were categorised as high-volume (>50 cases/year) or low volume (≤50 cases/year) based on their annual operative caseload. Clinical and perioperative outcomes were compared between the two groups. Results Of the 564 patients, 178 (31.6%) were performed by high-volume surgeons and 386 (68.4%) by low-volume surgeons.High-volume surgeonn=178Low-volume surgeons n=386P valueMedian Age55 years (IQR 40-63)53 years (IQR 38-63)0.355Female114 (64%)291 (75.4%)0.005Emergency Cases79 (44.4%)131 (33.9%)0.017Intra-operative cholangiogram117 (65.7%)95 (24.6%)<0.001Bile duct exploration51 (28.7%)21 (5.4%)<0.001Subtotal cholecystectomy9 (5.1%)44 (11.4%)0.016Median post-operative length of stay1 day (IQR 0-2)1 day (IQR 0-3)0.042Readmission within 30 days7 (3.9%)31 (8%)0.071Complications:Clavien-Dindo 1-211 (6.2%)26 (6.7%)0.804Clavien-Dindo 3-45 (2.8%)29 (7.5%)0.029 Conclusions Higher surgical volumes are associated with better outcomes in LC, despite increased case complexity. These findings support subspecialisation and suggest that gallstone surgery should be concentrated among dedicated surgeons to optimise patient safety, efficiency, and overall surgical quality.