| Autor: |
Glaysher, Michael A., May-Miller, Peter, Carter, Nicholas C., van Boxel, Gijs, Pucher, Philip H., Knight, Benjamin C., Mercer, Stuart J. |
| Zdroj: |
Surgical Endoscopy; February 2023, Vol. 37 Issue: 2 p1038-1043, 6p |
| Abstrakt: |
Background: Despite overwhelming evidence of the clinical and financial benefit of urgent cholecystectomy, there is variable enthusiasm and uptake across the UK. In 2014, following the First National Emergency Laparotomy Audit Organisational Report, we implemented a specialist-led urgent surgery service, whereby all patients with gallstone-related pathologies were admitted under the direct care of specialist upper gastrointestinal surgeons. We have analysed 5 years of data to investigate the results of this service model. Methods: Computerised operating theatre records were interrogated to identify all patients within a 5-year period undergoing cholecystectomy. Patient demographics, admission details, length of stay, duration of surgery, and complications were analysed. Results: Between 01/01/2016 and 31/12/2020, a total of 4870 cholecystectomies were performed; 1793 (36.8%) were urgent cases and 3077 (63.2%) were elective cases. All cases were started laparoscopically; 25 (0.5%) were converted to open surgery—14 of 1793 (0.78%) urgent cases and 11 of 3077 (0.36%) elective cases. Conclusion: Urgent laparoscopic cholecystectomy is safe and feasible in most patients with acute gall bladder disease. Surgery under the direct care of upper gastrointestinal specialist surgeons is associated with a low conversion rate, low complication rate, and short hospital stay. Timing of surgery has no effect on conversion rate or complication rate. |
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