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ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1561769
Development and Validation of a Radiologically-Based Nomogram for Preoperative Prediction of Difficult Laparoscopic Cholecystectomy
Provisionally accepted- Department of General Surgery, Shijiazhuang People's Hospital, Shijiazhuang, China
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Background: Preoperative prediction of difficult laparoscopic cholecystectomy (DLC) remains challenging, as intraoperative anatomical complexity significantly increases complication risks. Current studies have not reached consensus on definitive risk factors for DLC.Materials and Methods: This retrospective study aimed to identify DLC risk factors and develop a predictive model. We analyzed clinical data from 265 patients undergoing laparoscopic cholecystectomy (LC) at the Department of General Surgery, Shijiazhuang People's Hospital, between September 2022 and June 2024. Risk factors were explored through least absolute shrinkage and selection operator (LASSO) regression, multivariate analysis, and receiver operating characteristic (ROC) curves, with a nomogram constructed for prediction.Results: Among 265 eligible patients, four independent risk factors were identified: thickness of gallbladder wall (P = 0.0007), cystic duct length (P < 0.0001), cystic duct diameter (P < 0.0001), and gallbladder neck stones (P = 0.0002). The nomogram demonstrated strong predictive performance, with an area under the curve (AUC) of 0.915 in the training cohort and 0.842 in the validation cohort. Calibration curves indicated excellent model fit.: The proposed predictive model integrating gallbladder neck stones, thickness of gallbladder wall, cystic duct length, and cystic duct diameter may assist surgeons in preoperative DLC risk stratification. Further validation through multicenter prospective studies is warranted.
Keywords: predictive model, laparoscopic cholecystectomy, Difficult laparoscopic cholecystectomy, nomogram, risk factor
Received: 16 Jan 2025; Accepted: 07 Apr 2025.
Copyright: © 2025 Zhu, Wang, Zhang, Wang, Ma and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ming Li, Department of General Surgery, Shijiazhuang People's Hospital, Shijiazhuang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.