Standardizing process in acute biliary disease.
laparoscopic cholecystectomy
length of stay
operative process
systems
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
Feb 2024
Feb 2024
Historique:
received:
09
11
2023
accepted:
01
12
2023
medline:
30
4
2024
pubmed:
30
4
2024
entrez:
30
4
2024
Statut:
ppublish
Résumé
The perioperative management of biliary disease (BD) is variable across institutions with suboptimal outcomes for patients and health care systems. This results in inefficient utilization of limited resources. The aim of the current study was to identify modifiable factors impacting patients' time to theater, intraoperative time, and time to discharge as the constituents of length of stay to guide creation of a perioperative management protocol to address this variability. Data were prospectively captured at Christchurch Hospital for all adult patients presenting for cholecystectomy between May 2015 and May 2022. Pre, post, and intraoperative factors were assessed for their impact on time to theater, operative time, and postoperative hours to discharge. Four thousand five hundred seventy-seven patients underwent cholecystectomy during the study period, of which 2807 (61%) were acute presentations and made up the cohort for analysis. Time to theater was significantly impacted by preoperative imaging type, while operative grade and the procedure type had the most clinically significant impact on operative time. Postoperatively time to discharge was significantly impacted by drain placement. Standardizing management of BD would likely result in significant savings for the health care system and improved outcomes for patients. The data seen here evidence the importance of appropriate imaging selection, intraoperative difficulty operative grade identification, and low suction drain selection. These data have been incorporated in a perioperative management protocol as standardization of care across the patient workflow in BD is a sensible approach for ensuring optimal use of scarce resources.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
456-465Informations de copyright
© 2023 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).
Références
Vohra, R. S., S. Pasquali, A. J. Kirkham, P. Marriott, M. Johnstone, P. Spreadborough, D. Alderson, et al. 2016. “Population‐based Cohort Study of Outcomes Following Cholecystectomy for Benign Gallbladder Diseases.” British Journal of Surgery 103(12): 1704–1715. https://doi.org/10.1002/bjs.10287.
Brunt, L. Michael, Daniel J. Deziel, Dana A. Telem, Steven M. Strasberg, Rajesh Aggarwal, Horacio Asbun, Jaap Bonjer, et al. 2020. “Safe Cholecystectomy Multi‐Society Practice Guideline and State‐Of‐The‐Art Consensus Conference on Prevention of Bile Duct Injury during Cholecystectomy.” Surgical Endoscopy 34(7): 2827–2855. https://doi.org/10.1007/s00464‐020‐07568‐7.
Griffiths, Ewen A., James Hodson, Ravi S. Vohra, Paul Marriott, Tarek Katbeh, Samer Zino, and Ahmad H. M. Nassar. 2019. “Utilisation of an Operative Difficulty Grading Scale for Laparoscopic Cholecystectomy.” Surgical Endoscopy 33(1): 110–121. https://doi.org/10.1007/s00464‐018‐6281‐2.
Thomas, R. Thousands “Getting Progressively Sicker” as Surgeries Pushed Back Further. Stuff.
Mollah, Taha, Harry Christie, Marc Chia, Prasenjit Modak, Kaushik Joshi, Trived Soni, and Kirby R. Qin. 2022. “Gallbladder‐associated Hospital Admission and Cholecystectomy Rates across Australia and Aotearoa New Zealand (2004–2019): Are We Over‐intervening?” Annals Hepato‐Biliary‐Pancreatic Sciences 26(April): 339–346. https://doi.org/10.14701/ahbps.22‐007.
Forbes, S. (2022) “Te Whatu Ora Criticised for “Lack of Action” over Middlemore’s Dysfunctional ED.” RNZ. https://www.rnz.co.nz/news/ldr/477063/te‐whatu‐ora‐criticised‐for‐lack‐of‐action‐over‐middlemore‐s‐dysfunctional‐ed
Bray, F., T. Balcaen, E. Baro, A. Gandon, G. Ficheur, and E. Chazard. 2019. “Increased Incidence of Cholecystectomy Related to Gallbladder Disease in France: Analysis of 807,307 Cholecystectomy Procedures over a Period of Seven Years.” The Journal of Visualized Surgery 156(3): 209–215. https://doi.org/10.1016/j.jviscsurg.2018.12.003.
Connor, Saxon J., William Perry, Leslie Nathanson, Thomas B. Hugh, and Thomas J. Hugh. 2014. “Using a Standardized Method for Laparoscopic Cholecystectomy to Create a Concept Operation‐specific Checklist.” International Hepato‐Pancreato‐Biliary Association 16(5): 422–429. https://doi.org/10.1111/hpb.12161.
Tranter‐entwistle I., Simcock C., Eglinton T., Connor S. A Prospective Cohort Study of Operative Outcomes in Laparoscopic Cholecystectomy Using Operative Dif Fi Culty Grade‐Adjusted CUSUM Analysis. 2023;35:1–4.
Topal, B., G. Peeters, A. Verbert, and F. Penninckx. 2007. “Outpatient Laparoscopic Cholecystectomy: Clinical Pathway Implementation Is Efficient and Cost Effective and Increases Hospital Bed Capacity.” Surgical Endoscopy and other Interventional Techniques 21(7): 1142–1146. https://doi.org/10.1007/s00464‐006‐9083‐x.
Nechay, Taras, Svetlana Titkova, Alexander Tyagunov, Mikhail Anurov, and Alexander Sazhin. 2021. “Modified Enhanced Recovery after Surgery Protocol in Patients with Acute Cholecystitis: Efficacy, Safety and Feasibility. Multicenter Randomized Control Study.” Updates in Surgery 73(4): 1407–1417. https://doi.org/10.1007/s13304‐021‐01031‐5.
Trevino, Colleen M., Karina M. Katchko, Amy L. Verhaalen, Marie L. Bruce, and Travis P. Webb. 2016. “Cost Effectiveness of a Fast‐Track Protocol for Urgent Laparoscopic Cholecystectomies and Appendectomies.” World Journal of Surgery 40(4): 856–862. https://doi.org/10.1007/s00268‐015‐3266‐3.
Fair, Lucas, John J. Squiers, Kimberly Jacinto, Matthew Perryman, Jennifer Misenhimer, Somer Blair, and Carlos Rodriguez. 2023. “Fast‐Track Nonelective Laparoscopic Cholecystectomy Is Safe and Feasible.” Journal of Surgical Research 281: 256–263. https://doi.org/10.1016/j.jss.2022.09.003.
Demouron, Marion, Marie Selvy, Jeanne Dembinski, François Mauvais, Nicolas Cheynel, Karem Slim, Charles Sabbagh, et al. 2022. “Feasibility and Effectiveness of an Enhanced Recovery Program after Early Cholecystectomy for Acute Calculous Cholecystitis: A 2‐Step Study.” Journal of the American College of Surgeons 234(5): 840–848. https://doi.org/10.1097/XCS.0000000000000123.
Henley, J., K. Connolly, S. Jones, and A. Giuffrida. ‘A Ticking Time Bomb’: Healthcare under Threat across Western Europe.
McPhillips, D. Hospitals in the US Are the Fullest They’ve Been throughout the Pandemic – but It’s Not Just Covid. CNN.
Quinn, R. 2022. “Surgery Cancellations and Delays Widespread as Hospitals Hit by Covid‐19, Flu.” RNZ. February 7, 2022. https://www.rnz.co.nz/news/national/470683/surgery‐cancellations‐and‐delays‐widespread‐as‐hospitals‐hit‐by‐covid‐19‐flu.
Sakowska, Magdalena M., and Saxon Connor. 2011. “Index Cholecystectomy for Management of Acute Gallstone Disease: A Change of Practice at a Major New Zealand Metropolitan Centre.” HPB 13(10): 687–691. https://doi.org/10.1111/j.1477‐2574.2011.00345.x.
Lin, A., P. Stiven, P. Bagshaw, and S. Connor. 2006. “Cholecystectomy Following Acute Presentation to a Major New Zealand Metropolitan Hospital: Change to the Timing of Surgery Is Needed.” New Zealand Medical Association 119(1239).
Sakowska, Magdalena M., Megan V. Thomas, Saxon Connor, and Ross Roberts. 2017. “Hospital‐wide Implementation of an Electronic‐Workflow Solution Aiming to Make Surgical Practice Improvement Easy.” ANZ Journal of Surgery 87(3): 143–148. https://doi.org/10.1111/ans.13805.
Wennmacker, Sarah Z., Nazim Bhimani, Aafke H. van Dijk, Thomas J. Hugh, and Philip R. de Reuver. 2019. “Predicting Operative Difficulty of Laparoscopic Cholecystectomy in Patients with Acute Biliary Presentations.” ANZ Journal of Surgery 89(11): 1451–1456. https://doi.org/10.1111/ans.15493.
Tranter‐Entwistle, Isaac, Tim Eglinton, Thomas J. Hugh, and Saxon Connor. 2022. “Use of Prospective Video Analysis to Understand the Impact of Technical Difficulty on Operative Process during Laparoscopic Cholecystectomy.” International Hepato‐Pancreato‐Biliary Association 24(12): 2096–2103. (Preprint). https://doi.org/10.1016/j.hpb.2022.07.013.
Buxbaum, James L., Syed M. Abbas Fehmi, Shahnaz Sultan, Douglas S. Fishman, Bashar J. Qumseya, Victoria K. Cortessis, Hannah Schilperoort, et al. 2019. “ASGE Guideline on the Role of Endoscopy in the Evaluation and Management of Choledocholithiasis.” Gastrointestinal Endoscopy 89(6): 1075.e15–1105.e15. https://doi.org/10.1016/j.gie.2018.10.001.
Chisholm, Phillip R., Arpan H. Patel, Ryan J. Law, Allison R. Schulman, Arti O. Bedi, Richard S. Kwon, Erik J. Wamsteker, et al. 2019. “Preoperative Predictors of Choledocholithiasis in Patients Presenting with Acute Calculous Cholecystitis.” Gastrointestinal Endoscopy 89(5): 977–983.e2. https://doi.org/10.1016/j.gie.2018.11.017.
Tranter‐Entwistle, Isaac, Holly Wang, Kenny Daly, Scott Maxwell, and Saxon Connor. 2021. “The Challenges of Implementing Artificial Intelligence into Surgical Practice.” World Journal of Surgery 45(2): 420–428. https://doi.org/10.1007/s00268‐020‐05820‐8.
Iranmanesh, Pouya, J.‐Louis Frossard, Béatrice Mugnier‐Konrad, Philippe Morel, Pietro Majno, Thai Nguyen‐Tang, Thierry Berney, et al. 2014. “Initial Cholecystectomy vs Sequential Common Duct Endoscopic Assessment and Subsequent Cholecystectomy for Suspected Gallstone Migration: A Randomized Clinical Trial.” JAMA 312(2): 137–144. https://doi.org/10.1001/jama.2014.7587.
Iranmanesh, Pouya, Olivier Tobler, Sandra De Sousa, J.‐Louis Frossard, Philippe Morel, and Christian Toso. 2017. “Prospective Validation of an Initial Cholecystectomy Strategy for Patients at Intermediate‐Risk of Common Bile Duct Stone.” Gastrointestinal Endoscopy 85(4): 794–802. https://doi.org/10.1016/j.gie.2016.08.015.
Lyu, Yunxiao, Yunxiao Cheng, Bin Wang, Sicong Zhao, and Liang Chen. 2018. “Early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: an Up‐To‐Date Meta‐Analysis of Randomized Controlled Trials.” Surgical Endoscopy 32(12): 4728–4741. https://doi.org/10.1007/s00464‐018‐6400‐0.
Gurusamy, Kurinchi Selvan, Rahul Koti, and Brian R. Davidson. 2013. “Routine Abdominal Drainage versus No Abdominal Drainage for Uncomplicated Laparoscopic Cholecystectomy.” Cochrane Database of Systematic Reviews 2013(9). https://doi.org/10.1002/14651858.CD006004.pub4.
Miura, Fumihiko, Kohji Okamoto, Tadahiro Takada, Steven M. Strasberg, Horacio J. Asbun, Henry A. Pitt, Harumi Gomi, et al. 2018. “Tokyo Guidelines 2018: Initial Management of Acute Biliary Infection and Flowchart for Acute Cholangitis.” Journal of Hepato‐Biliary‐Pancreatic Sciences 25(1): 31–40. https://doi.org/10.1002/jhbp.509.
Loozen, Charlotte S., Hjalmar C. van Santvoort, Peter van Duijvendijk, Marc G. H. Besselink, Dirk J. Gouma, Grard A. P. Nieuwenhuijzen, Johannes C. Kelder, et al. 2018. “Laparoscopic Cholecystectomy versus Percutaneous Catheter Drainage for Acute Cholecystitis in High Risk Patients (CHOCOLATE): Multicentre Randomised Clinical Trial.” BMJ 363: k3965. https://doi.org/10.1136/bmj.k3965.
Overby, D. Wayne, Keith N. Apelgren, William Richardson, and Robert Fanelli. 2010. “SAGES Guidelines for the Clinical Application of Laparoscopic Biliary Tract Surgery.” Surgical Endoscopy 24(10): 2368–2386. https://doi.org/10.1007/s00464‐010‐1268‐7.
Ahn, Yeri, Jennifer Woods, and Saxon Connor. 2011. “A Systematic Review of Interventions to Facilitate Ambulatory Laparoscopic Cholecystectomy.” HPB 13(10): 677–686. https://doi.org/10.1111/j.1477‐2574.2011.00371.x.
Stone, Alexander B., Christina T. Yuan, Michael A. Rosen, Michael C. Grant, Lauren E. Benishek, Elizabeth Hanahan, Lisa H. Lubomski, et al. 2018. “Barriers to and Facilitators of Implementing Enhanced Recovery Pathways Using an Implementation Framework: A Systematic Review.” JAMA Surgery 153(3): 270–278. https://doi.org/10.1001/jamasurg.2017.5565.
Jabbour, Mona, Amanda S. Newton, David Johnson, and Janet A. Curran. 2018. “Defining Barriers and Enablers for Clinical Pathway Implementation in Complex Clinical Settings.” Implementation Science 13(1): 1–13. https://doi.org/10.1186/s13012‐018‐0832‐8.
Arora, Manit, Ashish D. Diwan, and Ian A. Harris. 2013. “Burnout in Orthopaedic Surgeons: A Review.” ANZ Journal of Surgery 83(7–8): 512–515. https://doi.org/10.1111/ans.12292.