GECKO - Global Evaluation of Cholecystectomy Knowledge and Outcomes.

We are excited to announce the latest trainee led cohort study GECKO in partnership with the NIHR Global surgery unit.

If you enjoyed participating in HIPPO and COVIDSurg then please register your interest.as hospital lead: First check if your hospital is registered. If not already registered then please enter your interest as hospital lead.

Australian national ethics process has commenced and we will update Australian sites in late June once this has been approved.

First Australia GECKO meeting 19 June 2023 (to be confirmed)

First patient recruitment period opens 31 July 2023

Last patient recruitment period opens 6 November 2023

More information coming soon…

Australia Lead Associate Professor Amanda Dawson

BACKGROUND INFORMATION & RATIONALE

Introduction

Cholecystectomy is amongst the most common surgical operations performed worldwide. Surgical candidates are treated for biliary pathologies, such as biliary cholic, cholecystitis and gallstone pancreatisis [1,2]. In patients who are deemed fit for surgery, cholecystectomy can be perfomed under three main settings: (1) emergency setting at index admission; (2) elective setting with no previous admisisons; or (3) delayed setting with one or more previous gallbladder-related admissions [3].

The advent of laparoscopy fundementally evolved biliary surgery and quickly became the “gold standard” approach. Recent multicentre collaborative studies [3,4,5] have elucidated that the burden imposed on healthcare systems by laparoscopic cholecystectomies is primarily due to patient readmissions and complications arising from the operation, rather than perioperative mortality burden that was more commonly seen in open surgery [6]. As a result, national and international societies [7,8] have shifted their focus towards creating a culture of safety around this procedure, with the overarching goal of improving patient satisfaction and reducing hospital costs. Gupta et al. [9] described safe cholecystectomy as one that is “safe for both the patient (no bile duct/hollow viscus/vascular injury) and for the operating surgeon (no or minimal scope for litigation)”. The universal establishment of safe cholecystectomy is a complex process that relies not only on the operation itself, but also on various other factors such as promoting adequate training, improving hospital infrastructure, and enhancing peri-operative patient care.

There remains a paucity of evidence around the variations of safe provision of laparoscopic surgery for gallbladder disease interntionally, including low- and middle-income countries. To bridge this knowledge gap, the Global Evaluation of Cholecystectomy Knowledge and Outcomes (GECKO) study (GlobalSurg 4) will be an international collaborative effort, delivered by the GlobalSurg network [10], that will allow contemporaneous data collection on the quality of cholecystectomies using measures covering infrastructure, care processes and outcomes. It will be disseminated via contacts from the National Institute for Health and Care Research (NIHR) Global Surgery unit, leading emergency general surgeons and specialist organisations.