ArticleUpdates in surgery2026
Association between the Parkland grading scale score and postoperative complications according to the Clavien-Dindo classification in emergency laparoscopic cholecystectomy.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Laparoscopic cholecystectomy is the standard treatment for acute calculous cholecystitis. The Parkland grading scale was developed to assess intraoperative severity; however, its association with postoperative outcomes remains underexplored in low- and middle-income countries. This study aimed to evaluate the associations between the Parkland grading scale and postoperative complications according to the Clavien–Dindo classification in emergency laparoscopic cholecystectomy. A retrospective observational study was conducted including patients who underwent emergency laparoscopic cholecystectomy. The association between Parkland grades and postoperative complications was assessed using Spearman’s correlation. Multivariable logistic regression analysis was performed adjusting for age, sex, body mass index, ASA classification, and preoperative white blood cell count (per 1000 cells/µL increment). A total of 113 patients were included (median age 40 years [IQR 30–52]; 66.4% female). Minor complications occurred in 43.4% of patients, whereas major complications were infrequent (2.7%). A significant positive correlation was observed between Parkland grade and postoperative complications (Spearman’s rho = 0.625, p < 0.001). In multivariable analysis, each one-grade increase in Parkland score was independently associated with postoperative complications (adjusted OR 10.99; 95% CI 4.79–25.18; p < 0.001). Preoperative white blood cell count and ASA III–IV classification were also independently associated with postoperative complications. Higher Parkland grading scale scores are independently associated with increased postoperative complications following emergency laparoscopic cholecystectomy. The graded relationship between intraoperative severity and postoperative morbidity supports the role of the Parkland grading scale as an objective intraoperative tool for stratifying postoperative risk.
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