Timing of cholecystectomy following endoscopic sphincterotomy: a population-based study
Autor: | Wei Xiong, S. Morad Hameed, Brett D. Mador, O. Neely M. Panton, Avery B. Nathens |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Funnel plot Time Factors Databases Factual medicine.medical_treatment Population Gallstones Sphincterotomy Endoscopic Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine education Aged Cholangiopancreatography Endoscopic Retrograde education.field_of_study British Columbia business.industry Bile duct General surgery Length of Stay Middle Aged Hepatology medicine.disease Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Pancreatitis Female 030211 gastroenterology & hepatology Cholecystectomy business Abdominal surgery |
Zdroj: | Surgical Endoscopy. 31:2977-2985 |
ISSN: | 1432-2218 0930-2794 |
DOI: | 10.1007/s00464-016-5316-9 |
Popis: | Choledocholithiasis is commonly treated initially with endoscopic sphincterotomy, followed by cholecystectomy to definitively address the underlying problem of cholelithiasis. While the benefits of early cholecystectomy have been realized in other populations, the preferred timing for this subset of patients is less well established. We performed a large, population-based analysis to determine the frequency, benefits, and practice variance in regard to early cholecystectomy on a provincial level. Patients undergoing endoscopic sphincterotomy followed by cholecystectomy in British Columbia, Canada, from January 2001 to December 2011 were identified using fee-code billing data. Multiple databases were linked to obtain information on demographics, admissions, procedures, mortality, and census geographic data. Regression analysis was performed for length of stay (LOS) and additional procedures. Outcome data were risk adjusted for age, gender, comorbidities, socioeconomic status, and year of procedure. Variability of early cholecystectomy crude rates across census areas was determined using a funnel plot. There were 4287 eligible patients. Of these, 1905 (44.4%) underwent early cholecystectomy, defined as surgery within 14 days of sphincterotomy. Median interval to cholecystectomy was 2 days for the early cholecystectomy group and 61 days for delayed. There was a significant difference in hospital LOS favoring early cholecystectomy for patients with documented gallstone disease (p |
Databáze: | OpenAIRE |
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