CholeS Score for Duration of Laparoscopic Cholecystectomy

The CholeS Score predicts the likelihood of a prolonged (>90‑minute) laparoscopic cholecystectomy based on preoperative patient and gallbladder factors.

Age, years
< 400≥ 40+1.5
Gender
Female0Male+1
Indication
Pancreatitis0Colic, dyskinesia, or polyp+0.5Common bile duct stones+2Acalculous or cholecystitis+2.5
BMI
< 25025-35+1> 35+2
Common bile duct diameter
Normal0Dilated+2
Gallbladder wall
Normal0Thick+1.5
Pre-operative CT done
No0Yes+1.5
Intra-op cholangiogram planned
No0Yes+3
Number of previous surgical admissions
001-2+1> 2.5+2.5
ASA class
102+1> 2+2.5

使用適応

Used for adults undergoing elective laparoscopic cholecystectomy to estimate risk of prolonged operative time (>90 min) using preoperative factors (age, ASA class, BMI, prior surgical admissions, gallbladder wall thickness, CBD diameter). Helps optimize theatre scheduling, allocate appropriate surgical expertise, and improve consent and resource planning, with external validation showing moderate discrimination (AUC 0.708) 1.

洞察と注意事項

Predicts likelihood of operative time >90 min, but is only moderately accurate and externally validated with AUC 0.786 (200‑patient Mexican cohort) 1 [Level II evidence].

  • Best used for theatre planning, not clinical decision‑making.
  • Moderate discrimination only; performance varies by population.
  • Does not incorporate acute cholecystitis severity, an important driver of prolonged time.
  • Should not guide surgeon assignment or consent alone—supports workflow, not risk prediction.