Surgical Complexity Classification Index (SCCI): A New Patient Classification System for Clinical Management of Laparoscopic Cholecystectomy

Objective.To devise a classification system of patients subjected to elective laparoscopic cholecystectomy (LC) which will enable the degree of surgical difficulty and possible time in surgery to be correlated with clinical, ultrasound, associated comorbidity and age group variables. Material and method. A prospective observational study of 110 patients subjected to LC in which the SCCI (Surgical Complexity Classification Index) had been calculated. The SCCI was worked out from previous studies published on patient classification systems and complication predictive factors in patients subjected to LC. Main outcome measures: surgical technique difficulty score, length of surgical time, post-operative stay (ambulatory). Results. The cut-off value that obtained a better classification of the patients was an SCCI > in whom the technique difficulty score was 13.2 (3.6) and the duration of the surgery 51.9 (31) compared with the SCCI <5 subgroup, technical difficulty score 10.5 (2.8) and the duration of the surgery 6.9 (11.4) ( P<.05). Conclusions. The SCCI enables the technical complexity of LC to be estimated and therefore appropriate risk management in the LC process together with improved clinical management of that process.