D Rutledge1, D Jones, R Rege. 1. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Abstract
BACKGROUND: Delay of laparoscopic cholecystectomy after the diagnosis of uncomplicated biliary disease is common at our institution. This study assessed the effect of delay of operation for symptomatic biliary disease. METHODS: A cohort of 251 patients was retrospectively reviewed at Parkland Memorial Hospital with follow-up available for 168 patients (67%) from January 1998 to July 1998. Data were analyzed using Student's t test and the chi-square test. RESULTS: Of the 88 patients with the initial diagnosis of biliary colic, 69 (78%) underwent elective laparoscopic cholecystectomy. Thirty-six patients made a total of 44 return visits the emergency department with a recurrent attack of biliary colic or a complication of gallstone disease. Mean operative time increased from 94 minutes for elective operations to 122 minutes for nonelective operations and hospital stay increased from 0.6 days to 6.1 days. Conversion to open operation increased from 6% in the elective group to 26% in the nonelective group. CONCLUSION: Delay of surgical therapy is associated with complications, increased operative times, higher conversion to open cholecystectomy, and prolonged hospitalization. We conclude that patients with symptomatic cholelithiasis should undergo early cholecystectomy.
BACKGROUND: Delay of laparoscopic cholecystectomy after the diagnosis of uncomplicated biliary disease is common at our institution. This study assessed the effect of delay of operation for symptomatic biliary disease. METHODS: A cohort of 251 patients was retrospectively reviewed at Parkland Memorial Hospital with follow-up available for 168 patients (67%) from January 1998 to July 1998. Data were analyzed using Student's t test and the chi-square test. RESULTS: Of the 88 patients with the initial diagnosis of biliary colic, 69 (78%) underwent elective laparoscopic cholecystectomy. Thirty-six patients made a total of 44 return visits the emergency department with a recurrent attack of biliary colic or a complication of gallstone disease. Mean operative time increased from 94 minutes for elective operations to 122 minutes for nonelective operations and hospital stay increased from 0.6 days to 6.1 days. Conversion to open operation increased from 6% in the elective group to 26% in the nonelective group. CONCLUSION: Delay of surgical therapy is associated with complications, increased operative times, higher conversion to open cholecystectomy, and prolonged hospitalization. We conclude that patients with symptomatic cholelithiasis should undergo early cholecystectomy.
Authors: Juliane Bingener-Casey; Melanie L Richards; William E Strodel; Wayne H Schwesinger; Kenneth R Sirinek Journal: J Gastrointest Surg Date: 2002 Nov-Dec Impact factor: 3.452
Authors: S Morad Hameed; Frederick D Brenneman; Chad G Ball; Joe Pagliarello; Tarek Razek; Neil Parry; Sandy Widder; Sam Minor; Andrzej Buczkowski; Cailan Macpherson; Amanda Johner; Dan Jenkin; Leanne Wood; Karen McLoughlin; Ian Anderson; Doug Davey; Brent Zabolotny; Roger Saadia; John Bracken; Avery Nathens; Najma Ahmed; Ormond Panton; Garth L Warnock Journal: Can J Surg Date: 2010-04 Impact factor: 2.089
Authors: Juliane Bingener; Kristine M Thomsen; Andrea McConico; Erik P Hess; Elizabeth B Habermann Journal: J Surg Res Date: 2014-06-19 Impact factor: 2.192
Authors: Marc G Besselink; Niels G Venneman; Peter M Go; Ivo A Broeders; Peter D Siersema; Hein G Gooszen; Karel J van Erpecum Journal: J Gastrointest Surg Date: 2008-10-24 Impact factor: 3.452