{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T23:50:04Z","timestamp":1775778604867,"version":"3.50.1"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study applies object-centric process mining (OCPM) techniques to analyze laparoscopic cholecystectomy (LC) procedures. Traditional process mining techniques are limited in analyzing workflows involving multiple interacting entities (patients, surgeries, anesthesia physical status, etc.).<\/jats:p>\n                  <jats:p>This study aimed to construct an Object-Centric Event Log (OCEL) from LC procedures, discover multientity process patterns, identify workflow bottlenecks, and analyze how patient complexity affects perioperative dynamics.<\/jats:p>\n                  <jats:p>An OCEL representing 1,186 LC cases (1,108 performed, 78 cancelled) from the University of California, Irvine Medical Center (UCIMC) was analyzed, using PM4Py to obtain object-centric directly-follows graphs (OC-DFG) and variant explorer. Statistical comparisons examined intensive care unit (ICU) admission and the American Society of Anesthesiologists (ASA) classification effects on perioperative duration using Mann\u2013Whitney U and Kruskal\u2013Wallis tests.<\/jats:p>\n                  <jats:p>Process discovery revealed a 92% adherence to the reference clinical pathway. ICU-admitted patients (n\u2009=\u2009353, 31.6%) demonstrated significantly longer perioperative durations than non-ICU patients (n\u2009=\u2009765, median 13.83 vs. 8.85\u2009hours, p\u2009&lt;\u20090.001, Cohen's d\u2009=\u20090.81). The ASA rating showed no significant effect on total perioperative time (p\u2009=\u20090.824). Major bottlenecks included booking-to-operating room (OR) transfer (median 7.2\u2009hours), preanesthesia preparation delays (28\u2009minutes in 5.6% of cases), and postanesthesia care unit (PACU) discharge (median 19.5\u2009hours, interquartile range [IQR]: 6.3\u201342.1\u2009hours). Pathway completeness was 99.1% with minimal documentation errors. Handoff efficiency varied substantially, with OR-to-PACU transfers occurring rapidly (median: 6\u2009minutes) but PACU-to-discharge transitions exhibiting extreme variability.<\/jats:p>\n                  <jats:p>OCPM enables multiperspective insights invisible to traditional case-centric approaches. While intraoperative phases function efficiently, preoperative scheduling and postoperative discharge represent primary bottlenecks. The high ICU admission rate (31.6%) likely reflects institutional case mix and data classification practices rather than true critical care needs. Targeted interventions addressing preoperative scheduling optimization, discharge bottlenecks, and real-time monitoring could substantially improve surgical throughput.<\/jats:p>","DOI":"10.1055\/a-2832-9369","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T23:58:11Z","timestamp":1773446291000},"page":"204-212","source":"Crossref","is-referenced-by-count":0,"title":["Object-Centric Process Mining of Laparoscopic Cholecystectomy Workflows: Identifying Bottlenecks and Optimization Opportunities"],"prefix":"10.1055","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3063-6272","authenticated-orcid":false,"given":"Ufuk","family":"Celik","sequence":"additional","affiliation":[{"name":"Bandirma Onyedi Eylul University, Omer Seyfettin Faculty of Applied Sciences, Management Information Systems Department, Balikesir, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"issue":"17","key":"ref1","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1001\/jama.2018.3438","article-title":"Laparoscopic cholecystectomy","volume":"319","author":"S S Kim","year":"2018","journal-title":"JAMA"},{"issue":"01","key":"ref2","first-page":"89","article-title":"The first laparoscopic cholecystectomy","volume":"5","author":"W Reynolds Jr","year":"2001","journal-title":"JSLS"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"4763","DOI":"10.1007\/s00464-018-6224-y","article-title":"High-resolution standardization reduces delay due to workflow disruptions in laparoscopic cholecystectomy","volume":"32","author":"M von Strauss Und Torney","year":"2018","journal-title":"Surg Endosc"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s00464-023-10482-3","article-title":"Automated segmentation of phases, steps, and tasks in laparoscopic cholecystectomy using deep learning","volume":"38","author":"S R Hegde","year":"2024","journal-title":"Surg Endosc"},{"key":"ref5","volume-title":"Towards Organizational Digital Twins: Process Enhancement by Object-Centric Simulation. 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