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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Panagiotopoulou, Ioanna G. Carter, Nicholas Lewis, Mark C. Rao, Sudhindra |
| Description | Country affiliation: United kingdom Author Affiliation: Panagiotopoulou IG ( Department of General Surgery, Dorset County Hospital, Dorchester, UK. yianna@doctors.org.uk) |
| Abstract | BACKGROUND: Early laparoscopic cholecystectomy (ELC) is becoming the accepted treatment for the management of acute gallstone disease in specialist centres. It has also been achieved safely in the district general hospital (DGH) setting. We audited the management of acute gallstone disease in our DGH and set about to see if we could implement ELC safely and effectively. PATIENTS AND METHODS: A retrospective audit of 2 years of practice was performed using our hospital-computerised systems. Following this, departmental education regarding the benefits of early cholecystectomy was widely disseminated. Management guidelines were altered to promote and consider ELC for all suitable patients. A prospective audit of practice was then performed for 6 months. RESULTS: The first cycle revealed that only 10.42% of emergency patients admitted with gallstone-related disease had ELC. In the second cycle, 63 patients were admitted with acute gallstone disease. Three died from acute pancreatitis. Twenty-one (58%) of the 36, who were deemed suitable, had ELC. Fifteen (42%) had planned delayed laparoscopic cholecystectomy (DLC), with six (40%) being readmitted whilst waiting for their elective surgery (all undergoing ELC during their readmission). Conversion rates were similar between all groups. One of the patients having DLC had a bile leak, which settled following Endoscopic Retrograde Cholangiopancreatography and stent. CONCLUSION: We were able to increase ELC rates following the implementation of necessary changes. There did not appear to be any difference in conversion or morbidity rates between ELC and DLC. We conclude ELC is safe and feasible in the DGH setting. |
| File Format | HTM / HTML |
| ISSN | 17441595 |
| Issue Number | 2 |
| Volume Number | 10 |
| e-ISSN | 17441609 |
| Journal | International Journal of Evidence-Based Healthcare |
| Language | English |
| Publisher | Wolters Kluwer Health |
| Publisher Date | 2012-06-01 |
| Publisher Place | Australia |
| Access Restriction | Subscribed |
| Subject Keyword | Discipline Health Services Cholecystectomy, Laparoscopic Methods Gallstones Surgery Hospitals, District Hospitals, General Acute Disease Adverse Effects Feasibility Studies Humans Medical Audit Prospective Studies Retrospective Studies Time Factors Treatment Outcome Journal Article |
| Content Type | Text |
| Resource Type | Article |
| Subject | Public Health, Environmental and Occupational Health Health Policy |
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