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Updates in surgery

Artificial intelligence assessment of Parkland's grading scale in laparoscopic cholecystectomy: a step toward real-world outcome prediction

In routine use of a surgical AI platform, the study automatically assigned Parkland Grading Scale scores across 249 consecutive laparoscopic cholecystectomies, grouped them into Low (PGS 1-2, n=78) and High (PGS 3-5, n=171) severity, compared surgical outcomes, and evaluated model F1, discrimination (AUC 0.932 and 0.896) and calibration against two surgeons' independent double reviews of a 75-video sample, finding that the High group had older age, higher ASA scores, more cholecystitis and urgent surgery, longer operative duration, more intraoperative events and bailouts, longer hospital stay, and more 90-day major complications and readmissions, with operative duration and hemorrhage-related events remaining significant after case-control matching (n=84).