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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | Acute uyeloid leukemia and acute promyelocytie leukemia显示文摘 | Lowenberg B Griffin JD Tallman MS | 2003 | Hematology2003，，： | 2 |
| 3 | Effect of disulfide bond- containing protein on rice starch gelatinization and pasting显示文摘 | Hamaker B R Griffin V K | 1993 | Cereal Chem1993，70，4： | 1 |
| 4 | Work and/or fun: Measuring hedonic and utilitarian shopping显示文摘 | Babin B J Darden W R Griffin M | 1994 | Journal of Consumer Research1994，20，4： | 1 |
| 5 | Biotin supply affects expression of biotin transporters, biotinylation of carboxylases and metabolism of interleukin-2 in Jurkat cells 显示文摘 | MAY K C GRIFFIN J B ZEMPLENI J | 2002 | Journal of Nutrition2002，132，5： | 1 |
| 6 | Continental growth in the Phanerozoic:Evidence from Central Asia显示文摘 | Jahn B M Griffin W L Windley B F | 2000 | Tectonophysics2000，328，： | 1 |
| 7 | Safety and efficacy of the extended iliofemoral approach in the treatment of complex fractures of the acetabulum显示文摘 | Griffin D B Beaule P E Matta J M | 2008 | J Bone Joint Surg Br2008，87，10： | 1 |
| 8 | 1H detected ^1H, ^15N correlation spectroscopy in rotating solids显示文摘 | Reif B Griffin R G | 2003 | J Magn Reson2003，1，： | 1 |
| 9 | Neoproterozoic re- cycling of the Sveconorwegian orogenic belt: Detrital-zircon data from the Sparagmite basins in the Scandinavian Cale- donides 显示文摘 | Bingen B Belousova E A Griffin W L | 2011 | Precambrian Research2011，189，： | 1 |
| 10 | The evolution of myocardial ischemia during percutaneous transluminal coronary angioplasty显示文摘 | Griffin B Timmis AD Crick JCP | 1987 | Eur Heart J1987，8，4： | 1 |
| 11 | Rapid optimal mul- tiburn ascent planning and guidance显示文摘 | Lu P Griffin B Dukeman G | 2008 | Journal of Guid- ance Control and Dynamics2008，31，6： | 1 |
| 12 | SHRIMP U-Ph Ages of Perovskite from Yakutian Kimberlites 显示文摘 | KINNY P GRIFFIN B J HEAMAN L M | 1997 | Russian Geology and Geophysics1997，38，1： | 1 |
| 13 | Lactococ- cus lactis - expressing listeriolysin O ( LLO ) provides protection and specific CD8 ( + ) T cells against Listeria monocytogenes in the murine infection model显示文摘 | BAHEY EL DIN M CASEY P G GRIFFIN B T | 2008 | Vaccine2008，26，41： | 1 |
| 14 | Material and process limits of silicon VLSI technology显示文摘 | PLUMMER J D GRIFFIN P B | 2001 | Proc IEEE2001，89，3： | 1 |
| 15 | Multriesidue determi-nation of sulfonamides in edible catfish,shrimp and salmon tissues by high-performance liquid chromatography with postcolumn derivatization andfluorescence detection显示文摘 | GEHRING T A GRIFFIN B WILLIAMS R | 2006 | J Chromatography B2006，840，2： | 1 |
| 16 | Reliable genotyping of samples with very low DNA quantities using PCR显示文摘 | Taberlet P Griffin S Goossens B | 1996 | Nucleic Acids Res1996，24，： | 1 |
| 17 | Clonogenic cells in acute myeloblastic leukemia显示文摘 | Griffin J Lowenberg B | 1986 | Blood1986，68，6： | 1 |
| 18 | The Stable Paths Problem and Interdomain Routing显示文摘 | Griffin T Shepherd F B Wilfong G | 2002 | IEEE/ACM transactions on Networking2002，10，1： | 1 |
| 19 | Detection of channel cat- fish virus DNA in acutely infected channel catfish, Ictalurus punc- tatus (Rafinesque) , using the polymerase chain reaction 显示文摘 | Gray W L Williams R J Griffin B R | 1999 | J Fish Dis1999，22，2： | 1 |
| 20 | Simultaneous inhibition of the receptor kinase activity of vascular endothelial, fibroblast, and platelet-derived growth factors suppresses tumor growth and enhances tumor radiation response显示文摘 | Griffin R J Williams B W Wild R | 2002 | Cancer Res2002，62，6： | 1 |
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