Reducing waiting lists for laparoscopic cholecystectomy: An intensive approach to aid COVID-19 recovery
| Autor: | Kunal Rajput, Anil Kaul, Chyu Yan Naing, Rachael Elizabeth Clifford, Thomas Pantak, Karen MacDonald |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Gallstones Biliary colic 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Pandemic medicine Training Cholecystectomy Coronavirus disease 2019 business.industry Waiting lists General surgery Vascular surgery medicine.disease Cardiac surgery 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Original Article medicine.symptom business Abdominal surgery |
| Zdroj: | European Surgery |
| ISSN: | 1682-8631 |
| Popis: | Summary Background Laparoscopic cholecystectomy is one of the most frequently performed operations in the United Kingdom, commonly due to symptomatic gallstones. Delay between diagnosis and definitive surgical intervention often leads to a significant readmission rate, growing financial burden and increased complexity of the ultimate surgical intervention. Resource reallocation and reduced operational capacity during the coronavirus disease 2019 (COVID-19) pandemic has led to an impending waiting list crisis. Methods In an attempt to address the backlog of cases, five intensive dedicated operating lists were allocated for laparoscopic cholecystectomies across a weekend in October 2020 at a single Trust. Prospective data were collected to include baseline demographics, operative procedure, 30-day post-operative outcomes and financial implications. Results A total of 21 cholecystectomies were performed in total, with a majority ASA 2 (American Society of Anaesthesiologists) for predominantly biliary colic indication. All were completed laparoscopically, with a 90.5% rate for complete resection. There were no reported on-table complications and 81.0% of patients discharged as a day case. Thirty day follow-up revealed a complication rate of 9.5%, with 2 patients requiring oral antibiotics for a superficial wound infection. The 30 day COVID-19 rate was 14.3%. Compared to completion on an average weekday list, the total weekend was estimated to have saved over £70,000 in overall costs. Conclusion Our study showed that weekend focused operating, with a caveat of careful patient selection and high-quality multidisciplinary working, can be a feasible solution to long waiting lists due to COVID-19 pandemic. It was safe, with avoidance of increased burden on emergency resources, and significantly increased theatre efficiency. |
| Databáze: | OpenAIRE |
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