Establishing benchmarks for the management of elevated liver enzymes and/or dilated biliary trees in an urban safety net hospital: analysis of 915 subjects.

Autor: Liu L; Department of Surgery, UT Southwestern Medical Center, Parkland Memorial Hospital, Dallas, TX, USA., Cripps MW; Department of Surgery, UT Southwestern Medical Center, Parkland Memorial Hospital, Dallas, TX, USA., Riggle AJ; Department of Surgery, UT Southwestern Medical Center, Parkland Memorial Hospital, Dallas, TX, USA., Wolf SE; Division of Burns/Trauma/Critical Care, Department of Surgery, UT Southwestern Medical Center, Parkland Memorial Hospital, 5323 Harry Hines Blvd., E5.508A, Dallas, TX 75390-9158, USA., Nakonezny PA; Division of Biostatistics, Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, USA., Phelan HA; Division of Burns/Trauma/Critical Care, Department of Surgery, UT Southwestern Medical Center, Parkland Memorial Hospital, 5323 Harry Hines Blvd., E5.508A, Dallas, TX 75390-9158, USA. Electronic address: herb.phelan@utsouthwestern.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2015 Dec; Vol. 210 (6), pp. 1132-7; discussion 1137-9. Date of Electronic Publication: 2015 Sep 26.
DOI: 10.1016/j.amjsurg.2015.07.009
Abstrakt: Background: The push for public reporting of outcomes necessitates relevant benchmarks for disease states across different settings. This study establishes benchmarks for choledocholithiasis management in a safety net hospital setting.
Methods: We reviewed all patients admitted to our acute care surgery service with biochemical evidence of choledocholithiasis who underwent same-admission cholecystectomy (CCY) between July 2012 and December 2013.
Results: During this 18-month period, 915 patients were admitted with biochemical evidence of choledocholithiasis. Descriptive statistics for the cohort are provided, which include a 51% rate of obesity and 95% rate of pathologic cholecystitis. Conversion rates of 4% and complication rates of 6% were found. The majority had a CCY without biliary imaging (n = 630, 68.9%).
Conclusions: Relevant benchmarks are characterized, and results of a practice pattern of omitting pre- or intraoperative biliary tree imaging are described. These findings serve as a first benchmark of choledocholithiasis management for urban safety net hospitals.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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