As surgical complexity increases and patient comorbidity burden rises, evaluating contemporary outcomes becomes increasingly important. In this large cohort study of 516,372 Medicare beneficiaries undergoing inpatient minimally invasive cholecystectomy (2011–2021), risk-adjusted outcomes improved significantly over time. Overall complication rates declined from 21.5% to 16.5%, and serious complications decreased from 12.3% to 7.0% (P<.001), despite a growing proportion of unplanned admissions and higher comorbidity profiles.
Importantly, rates of intraoperative hemorrhage, transfusion, and bile duct injury all decreased substantially. However, postoperative percutaneous drainage more than doubled (1.32% to 2.91%; P<.001), suggesting evolving perioperative management practices rather than declining safety. These findings reflect meaningful advances in minimally invasive biliary surgery…
