| Autor: |
Knight, J.S., Mercer, S.J., Jancewicz, S., Walters, A.M., Sadek, S.A., Toh, S.K.C., Somers, S.S. |
| Předmět: |
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| Zdroj: |
British Journal of Surgery; Jun2003 Supplement 1, Vol. 90, p95, 1/3p |
| Abstrakt: |
Aims: The gold standard treatment for acute cholecystitis (AC) and biliary colic (BC) requiring hospital admission is urgent laparoscopic cholecystectomy. Due to constraints on surgical and theater time, this is often not achieved in the UK. Methods: An audit was carried out of all emergency admissions with AC or BC to Queen Alexandra Hospital in the year 2000. On the basis of the findings, a specialist-led protocol was designed for the improved management of acute gallstone disease. A further audit was carried out 6 months after implementation of the protocol. Results: 158 patients were admitted with AC or BC in the first audit period, and 110 in the second audit period. The rate of cholecystectomy at index admission increased from 37% to 67%, at a median time of 3 days after admission, and the conversion rate fell from 32% to 12%. The median operation time was 75 minutes, and there was an acceptable complication rate. The median hospital stay for these patients fell from 9 days to 5 days, and the unplanned readmission rate was reduced from 19% to 4% of patients. Conclusion: Urgent cholecystectomy for the management of acute cholecystitis and biliary colic is feasible and achievable in a DGH with a specialist upper GI team. It can lead to lower conversion rates, shorter hospital stay and fewer unplanned readmissions with an acceptable operating time and complication rate. The protocol is recommended for implementation in other hospitals. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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