{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:19:48Z","timestamp":1783649988642,"version":"3.55.0"},"reference-count":17,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NIHR Global Health Group on Global Surgery","award":["NIHR16.136.79"],"award-info":[{"award-number":["NIHR16.136.79"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,6,17]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>Cholecystectomy is one of the most common operations performed worldwide. Although laparoscopic surgery has been the \u2018gold-standard\u2019 approach for this operation, there is a paucity of global evidence around the variations of safe provision of cholecystectomy, including low-income and middle-income countries. This international collaborative study will allow contemporaneous data collection on the quality of cholecystectomies using measures covering infrastructure, care processes and outcomes, with the primary aim define the global variation in compliance with preoperative, intraoperative and postoperative audit standards.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods and analysis<\/jats:title>\n<jats:p>Global Evaluation of Cholecystectomy Knowledge and Outcomes is a prospective, international, multicentre, observational cohort study delivered by the GlobalSurg Collaborative. Consecutive patients undergoing cholecystectomy between 31 July 2023 and 19 November 2023 will be recruited, with follow-up at 30 days and 1-year postoperatively. The study will be undertaken at any hospital providing emergency or elective surgical services for biliary disease. The primary endpoint of this study is compliance with preoperative, intraoperative and postoperative audit standards. Secondary outcomes include rates of 30-day complications, achievement of critical view of safety and rates of gallbladder cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Ethics and dissemination<\/jats:title>\n<jats:p>This project will not affect clinical practice and has been classified as clinical audit following research ethics review at University Hospital Birmingham NHS Trust. The protocol will be disseminated through the international GlobalSurg and CovidSurg network.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Trial registration number<\/jats:title>\n<jats:p>\n<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06223061\">NCT06223061<\/jats:ext-link>\n.\n<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079599","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T18:52:03Z","timestamp":1722019923000},"page":"e079599","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Global evaluation and outcomes of cholecystectomy: protocol for a multicentre, international, prospective cohort study (GlobalSurg 4)"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct06223061","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Ewen","family":"Harrison","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2748-0011","authenticated-orcid":false,"given":"Sivesh","family":"Kathir Kamarajah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"2024072522351808000_14.7.e079599.1","doi-asserted-by":"crossref","first-page":"6403","DOI":"10.1007\/s00464-021-08986-x","article-title":"Elective laparoscopic cholecystectomy: recurrent biliary admissions predispose to difficult cholecystectomy","volume":"36","author":"Lucocq","year":"2022","journal-title":"Surg Endosc"},{"key":"2024072522351808000_14.7.e079599.2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10287"},{"key":"2024072522351808000_14.7.e079599.3","doi-asserted-by":"crossref","DOI":"10.1093\/bjsopen\/zrac088","article-title":"Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)","volume":"6","year":"2022","journal-title":"BJS Open"},{"key":"2024072522351808000_14.7.e079599.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-0988-2"},{"key":"2024072522351808000_14.7.e079599.5","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s13017-021-00369-w","article-title":"WSES guidelines for the detection and management of bile duct injury during cholecystectomy","volume":"16","author":"de\u2019Angelis","year":"2021","journal-title":"World J Emerg Surg"},{"key":"2024072522351808000_14.7.e079599.6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/SLA.0000000000003791","article-title":"Safe cholecystectomy multi-society practice guideline and state-of-the-art consensus conference on prevention of bile duct injury during cholecystectomy","volume":"272","author":"Brunt","year":"2020","journal-title":"Ann Surg"},{"key":"2024072522351808000_14.7.e079599.7","doi-asserted-by":"crossref","first-page":"62","DOI":"10.4240\/wjgs.v11.i2.62","article-title":"Safe laparoscopic cholecystectomy: adoption of universal culture of safety in cholecystectomy","volume":"11","author":"Gupta","year":"2019","journal-title":"World J Gastrointest Surg"},{"key":"2024072522351808000_14.7.e079599.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30101-4"},{"key":"2024072522351808000_14.7.e079599.9","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S0140-6736(21)00001-5","article-title":"NIHR global health unit on global surgery. global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries","volume":"397","year":"2021","journal-title":"Lancet"},{"key":"2024072522351808000_14.7.e079599.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62013-9"},{"key":"2024072522351808000_14.7.e079599.11","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10151"},{"key":"2024072522351808000_14.7.e079599.12","doi-asserted-by":"crossref","DOI":"10.1186\/s13017-021-00369-w","article-title":"2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy","volume":"16","author":"de\u2019Angelis","year":"2021","journal-title":"World J Emerg Surg"},{"key":"2024072522351808000_14.7.e079599.13","unstructured":"Maynard N , Beckingham I . Association of upper gastrointestinal surgeons of great britain and Ireland.the provision of services for upper gastrointestinal surgery. 2016. 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