The effect of checklists on the surgical performance during laparoscopic cholecystectomy: A systematic review

Aims: Laparoscopic cholecystectomy (LC) is known to be one of the most widely performed general surgical operations. However, it is still associated with an increased incidence and severity of complications especially during the period of a surgeon’s proficiency-gain curve. Certain complications could be prevented by decreasing the incidence and consequences of surgeon errors. We aimed to systematically review the use of checklists during LC and their effect on the surgical task performance.
Methods: A systematic review was performed in compliance with the PRISMA guidelines. A search was carried out on PubMed, ScienceDirect and the Cochrane-Library databases. English language articles published to November 2020 were included in this study. The terms included: ‘Checklist and laparoscopic cholecystectomy’, ‘checklist and laparoscopic surgery’, ‘checklist and cholecystectomy’ and checklist and minimally invasive surgery’’. MERSQI score was applied for quality assessment. The research protocol was registered with PROSPERO register (CRD42021209118).
Results: The results of the systematic search resulted in 8862 citations, of which 23 relevant citations were assessed for eligibility. A final 9 articles were included in this study. The endpoints were equipment related- risk events, numbers and types of adverse events, rate of conversion to open cholecystectomy, team communication and coordination, the number of consequential and inconsequential errors. The positive effect of checklists on the performance during LC was supported with 5 high-quality studies.
Conclusion: The effect of checklists application during LC showed a significant improvement of the surgical task performance by decreasing the number of surgeons’ errors. We envisage the routine use of checklists during LC.