| Autor: |
Pajak, Carla, Lee, Sharmen Vigouret, Konkin, Dave, Sidhu, Sue, Cowie, Scott |
| Předmět: |
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| Zdroj: |
British Columbia Medical Journal; Sep2018, Vol. 60 Issue 7, p352-357, 6p |
| Abstrakt: |
Background: Significant research has shown convincingly that managing acute cholecystitis with early laparoscopic cholecystectomy rather than delayed cholecystectomy is safe and is associated with improved outcomes and lower costs. However, early laparoscopic surgery is not routine, suggesting barriers to uniform adoption of this practice. Methods: An online survey of practising general surgeons in the Fraser Health Authority was followed by a retrospective audit of all patients presenting to health authority sites with acute cholecystitis from April 2012 to June 2013. A modest educational intervention was then implemented at Langley Memorial Hospital to facilitate adoption of early laparoscopic cholecystectomy. Data were compared from before and after implementation of the educational intervention. Some outcomes considered were times from admission to surgery, duration of operations, rates for conversion to open surgery, and length of stay. Results: The retrospective audit found that more than half of health authority patients (54%) did not receive early access to surgery, despite this approach being preferred by most surgeons. The comparison of management approaches before and after the educational intervention at Langley Memorial Hospital showed an 85% increase in early laparoscopic cholecystectomy rates and a 47% reduction in time from admission to surgery. Conclusions: Improving access to timely surgery is possible and requires engagement of key stakeholders. Policies aimed at increasing rates of early laparoscopic cholecystectomy for treatment of acute cholecystitis must focus on improving surgeon access to surgical resources. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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