Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis

Daniel Feng; Luke Petschack; Georgia Marr; Jon Gani

doi:doi:10.11648/j.js.20200806.20

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Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis

Daniel Feng, Luke Petschack, Georgia Marr, Jon Gani

Published in Journal of Surgery (Volume 8, Issue 6)

Received: 16 November 2020 Accepted: 7 December 2020 Published: 22 December 2020

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Abstract

Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (P<0.0001) in the ASU hospital and non-ASU hospitals respectively in patients with mild (Tokyo Grade I) disease. There was no difference between intraoperative cholangiogram rates between hospitals. The initial length of stay was on average 2.4 days shorter in the early ELC patients (MD=-2.4, 95% CI 1.3 to 3.4). The 2 Non-ASU hospitals varied significantly in ELC rates (19% and 48% P=0.0158), the hospital with the higher ELC rates shared senior surgical staff with the ASU hospital. Conclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.

Published in	Journal of Surgery (Volume 8, Issue 6)
DOI	10.11648/j.js.20200806.20
Page(s)	228-232
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Early Laparoscopic Cholecystectomy, Surgeon Preference, Acute Cholecystitis

References

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APA Style

Daniel Feng, Luke Petschack, Georgia Marr, Jon Gani. (2020). Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis. Journal of Surgery, 8(6), 228-232. https://doi.org/10.11648/j.js.20200806.20

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ACS Style

Daniel Feng; Luke Petschack; Georgia Marr; Jon Gani. Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis. J. Surg. 2020, 8(6), 228-232. doi: 10.11648/j.js.20200806.20

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AMA Style

Daniel Feng, Luke Petschack, Georgia Marr, Jon Gani. Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis. J Surg. 2020;8(6):228-232. doi: 10.11648/j.js.20200806.20

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@article{10.11648/j.js.20200806.20,
  author = {Daniel Feng and Luke Petschack and Georgia Marr and Jon Gani},
  title = {Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis},
  journal = {Journal of Surgery},
  volume = {8},
  number = {6},
  pages = {228-232},
  doi = {10.11648/j.js.20200806.20},
  url = {https://doi.org/10.11648/j.js.20200806.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200806.20},
  abstract = {Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (PConclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.},
 year = {2020}
}

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TY  - JOUR
T1  - Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis
AU  - Daniel Feng
AU  - Luke Petschack
AU  - Georgia Marr
AU  - Jon Gani
Y1  - 2020/12/22
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200806.20
DO  - 10.11648/j.js.20200806.20
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 228
EP  - 232
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200806.20
AB  - Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (PConclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.
VL  - 8
IS  - 6
ER  -

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Author Information

Daniel Feng

School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
Luke Petschack

School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
Georgia Marr

Department of Surgery, John Hunter Hospital, Newcastle, Australia
Jon Gani

School of Medicine and Public Health, University of Newcastle, Newcastle, Australia

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Plain Text BibTeX RIS

APA Style

Daniel Feng, Luke Petschack, Georgia Marr, Jon Gani. (2020). Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis. Journal of Surgery, 8(6), 228-232. https://doi.org/10.11648/j.js.20200806.20

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ACS Style

Daniel Feng; Luke Petschack; Georgia Marr; Jon Gani. Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis. J. Surg. 2020, 8(6), 228-232. doi: 10.11648/j.js.20200806.20

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AMA Style

Daniel Feng, Luke Petschack, Georgia Marr, Jon Gani. Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis. J Surg. 2020;8(6):228-232. doi: 10.11648/j.js.20200806.20

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@article{10.11648/j.js.20200806.20,
  author = {Daniel Feng and Luke Petschack and Georgia Marr and Jon Gani},
  title = {Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis},
  journal = {Journal of Surgery},
  volume = {8},
  number = {6},
  pages = {228-232},
  doi = {10.11648/j.js.20200806.20},
  url = {https://doi.org/10.11648/j.js.20200806.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200806.20},
  abstract = {Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (PConclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.},
 year = {2020}
}

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TY  - JOUR
T1  - Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis
AU  - Daniel Feng
AU  - Luke Petschack
AU  - Georgia Marr
AU  - Jon Gani
Y1  - 2020/12/22
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200806.20
DO  - 10.11648/j.js.20200806.20
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 228
EP  - 232
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200806.20
AB  - Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (PConclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.
VL  - 8
IS  - 6
ER  -

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