The GECKO Study (GlobalSurg-4) will be an international observational cohort study. The GlobalSurg Network collaborators will come together to collect contemporaneous data on the performance and outcomes of cholecystectomy. 

  • Cholecystectomy is amongst the commonest surgical procedures performed, treating patients for biliary pathologies such as biliary cholic and gallstone pancreatitis, in emergencies and elective admissions
  • Laparoscopy has evolved biliary surgery across the world. Despite mitigating the perioperative mortality burden of open surgery, laparoscopy imposes different burdens on the healthcare system, such as readmissions and operative complications.
  • Hence, there is a focus to improve patient satisfaction and reduce hospital costs
  • However, establishing universally safe cholecystectomy is a complex process, dependent on multiple factors such as adequate training, hospital infrastructure and enhanced peri-operative patient care
  • The Global Evaluation of Cholecystectomy Knowledge and Outcomes (GECKO) Study, aims to fill the gap in evidence on the variations of safe provision of laparoscopic gallbladder surgery internationally, including low- and middle-income countries

The primary aim is to define the global variation in compliance to pre-, intra-, and post-operative audit standards.

The secondary aims are to:

  • Determine quality of safe provision of cholecystectomy
  • Assess adverse events following cholecystectomy and their management
  • Analyse rates and outcomes of unsuspected gallbladder cancers
  • Evaluate the availability of cholecystectomy services and training
  • Assess sustainable practice in laparoscopic cholecystectomy
  • GECKO is a prospective, international, observational collaborative cohort study
  • Disseminated via contacts from the National Institute for Health and Care Research (NIHR) Global Surgery unit, leading emergency general surgeons and specialist organisations
  • Consecutive patients undergoing cholecystectomy, between 31st July – 19th November 2023, with follow-up at 30-day and one-year postoperatively
  • Age: All adult patients (greater than or including 18 years of age)
  • Procedure: Primary cholecystectomy, where this is the main procedure planned
  • Approach: Any Open, laparoscopic, robotic approaches are eligible
  • Urgency: Elective, delayed and emergency procedures
  • Procedure: Cholecystectomy as a part of another surgical procedure e.g., Whipple’s, bariatric, anti-reflux, transplant
  • Indication: Patients with Mirizzi syndrome
  • Return to theatre: Any patient returning to theatre and requiring a cholecystectomy for whatever indication, should not be included
  • Known gallbladder malignancy: Gallbladder cancer diagnosed pre-operatively

For the Study Protocol, please click here

For the site survey, click here

For the Data Dictionary, click here

For the Case Report Form (CRF), click here

For the Visual Abstract, click here

For the Participant Consent Form, click here

For the Participant Information Sheet, click here

Project Cheetah
Project Cheetah