Background: Although Enhanced Recovery After Surgery (ERAS) pathways improve postoperative outcomes, a uniform approach may not adequately reflect the heterogeneity of patients undergoing laparoscopic cholecystectomy (LC). Preoperative risk factors substantially influence recovery trajectories, length of hospital stay (LOS), and discharge readiness, highlighting the need for risk-stratified ERAS implementation. Methods: We conducted a focused, implementation-oriented review of studies published between January 2015 and June 2025, using a structured PubMed search, staged screening, and qualitative synthesis to identify preoperative predictors of prolonged LOS or delayed discharge after LC. Results: Across representative studies, consistently reported preoperative predictors included advanced age, higher American Society of Anesthesiologists physical status, acute cholecystitis, emergency surgery, diabetes mellitus, active smoking, and obesity. These variables were integrated into a pragmatic risk-stratification framework, categorizing patients into standard-, intermediate-, and high-risk groups. ERAS benefits varied across risk strata, with greater reductions in LOS observed in standard-risk patients, whereas safety, monitoring, and complication prevention predominated in high-risk patients. Surgical urgency (elective vs emergency LC) functioned as a contextual modifier within the risk-stratified framework rather than an isolated determinant of outcome. Conclusions: Risk-stratified ERAS implementation for LC enables individualized perioperative care by aligning recovery goals with patient vulnerability, procedural context, and institutional practice. This implementation-focused framework supports safer and more adaptable ERAS application across heterogeneous patient populations and provides a foundation for future prospective validation.
Jo et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: