Surgical complications in minimally invasive cholecystectomy have significantly decreased despite rising patient complexity.

• Overall complication rates fell from 21.5% in 2011 to 16.5% in 2021.
• Serious complications dropped from 12.3% to 7.0% in the same period.

Surgery has improved, with specific gains in intraoperative hemorrhage (1.07% to 0.54%) and blood transfusions (5.47% to 1.87%).

However, postoperative drainage rates nearly doubled, suggesting a shift in surgical practices that may need further evaluation.