Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis
Introduction While literature widely supports early cholecystectomy for mild gallstone pancreatitis (GSP), this has not been reflected in clinical practice. Early cholecystectomy for GSP with end organ dysfunction remains controversial. Objective This study aims to evaluate the rate and outcomes of...
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| Veröffentlicht in: | The American surgeon 2022-10, Vol.88 (10), p.2579-2583 |
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| creator | Liu, Jessica K. Braschi, Caitlyn de Virgilio, Christian M. Ozao-Choy, Junko Kim, Dennis Y. Moazzez, Ashkan |
| description | Introduction
While literature widely supports early cholecystectomy for mild gallstone pancreatitis (GSP), this has not been reflected in clinical practice. Early cholecystectomy for GSP with end organ dysfunction remains controversial.
Objective
This study aims to evaluate the rate and outcomes of early cholecystectomy ( |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2682260349</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_00031348221109488</sage_id><sourcerecordid>2682260349</sourcerecordid><originalsourceid>FETCH-LOGICAL-c318t-dce91a877e20f1aa4b3c459800bdce0222a7971a591faf1f249b5b72b952b19d3</originalsourceid><addsrcrecordid>eNp1kU9rGzEQxUVJoE7SD9CboJdcNtVoV9YqN-M4f8DULm3pcZmVtYnMWrIl7WG_feS4UGjoad4wv_cYZgj5DOwGQMqvjLESyqrmHICpqq4_kAkIIQpV8_KMTI7z4gh8JBcxbnNbTQVMyGGBoR_p_MX3Ro8xGZ38bqTW0Qfs-5i8M3SNTgeDySYbc5OscSnS3za9UHSbN-GHRBdZr8IzOno3xm5wOlnvbumMfvv-42lNZw77Mdp4Rc477KP59Kdekl_3i5_zx2K5eniaz5aFLqFOxUYbBVhLaTjrALFqS10JVTPW5hHjnKNUElAo6LCDjleqFa3krRK8BbUpL8n1KXcf_GEwMTU7G7Xpe3TGD7Hh03ysKSsrldEv_6BbP4S8b6ZkhiQTqswUnCgdfIzBdM0-2B2GsQHWHJ_QvHtC9tycPBGfzd_U_xteASX8hjk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2722670593</pqid></control><display><type>article</type><title>Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis</title><source>Access via SAGE</source><creator>Liu, Jessica K. ; Braschi, Caitlyn ; de Virgilio, Christian M. ; Ozao-Choy, Junko ; Kim, Dennis Y. ; Moazzez, Ashkan</creator><creatorcontrib>Liu, Jessica K. ; Braschi, Caitlyn ; de Virgilio, Christian M. ; Ozao-Choy, Junko ; Kim, Dennis Y. ; Moazzez, Ashkan</creatorcontrib><description>Introduction
While literature widely supports early cholecystectomy for mild gallstone pancreatitis (GSP), this has not been reflected in clinical practice. Early cholecystectomy for GSP with end organ dysfunction remains controversial.
Objective
This study aims to evaluate the rate and outcomes of early cholecystectomy (<3 days from admission) in mild GSP patients with end organ dysfunction (+EOD) and without (–EOD).
Methods
Patients with GSP without necrosis were identified from 2017 to 2019 NSQIP database and categorized into GSP±EOD. Coarsened Exact Matching was used to match patients based on preoperative risk factors in each group, and outcomes were compared.
Results
There was a total of 3104 patients –EOD and 917 +EOD in the aggregate cohort. Early cholecystectomy was performed in 1520 (49.0%) of GSP-EOD and in 407 (44.4%) of GSP+EOD. In the matched cohorts, there were no significant differences in 30-day mortality, morbidity, or reoperation for early cholecystectomy in either group. In GSP-EOD, early cholecystectomy was associated with shorter LOS (2.9 ± 1.5 vs. 5.6 ± 3.0 days, P < .001), shorter operative time (69.7 ± 34.4 vs. 73.3 ± 36.6 min, P = .045), and more concurrent biliary procedures (52.1% vs. 35.4%, P < .001). Similarly, early cholecystectomy in GSP+EOD was associated with shorter LOS (3.3 ± 1.8 vs. 6.9 ± 6.6 days, P < .001), shorter operative time (65.9 ± 32.1 vs. 76.0 ± 40.7, P < .001), and more concurrent biliary procedure (46.0% vs. 34.9%, P = .002).
Conclusions
This study supports early cholecystectomy in patients with mild GSP. Even with end organ dysfunction, early cholecystectomy appears to be safe given there is no difference in morbidity and mortality, and the potential benefit of reduced LOS.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/00031348221109488</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Ascites ; Body mass index ; Calculi ; Cholecystectomy ; Chronic obstructive pulmonary disease ; Diabetes ; Dyspnea ; Gallstones ; Heart failure ; Hispanic people ; Hypertension ; Kidneys ; Laparoscopy ; Length of stay ; Medical personnel ; Metastasis ; Morbidity ; Mortality ; Necrosis ; Pancreatitis ; Patients ; Quality improvement ; Risk analysis ; Risk factors ; Sepsis ; Steroids ; Ventilators</subject><ispartof>The American surgeon, 2022-10, Vol.88 (10), p.2579-2583</ispartof><rights>The Author(s) 2022</rights><rights>2022. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c318t-dce91a877e20f1aa4b3c459800bdce0222a7971a591faf1f249b5b72b952b19d3</citedby><cites>FETCH-LOGICAL-c318t-dce91a877e20f1aa4b3c459800bdce0222a7971a591faf1f249b5b72b952b19d3</cites><orcidid>0000-0003-4321-9734 ; 0000-0003-2706-746X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/00031348221109488$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/00031348221109488$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids></links><search><creatorcontrib>Liu, Jessica K.</creatorcontrib><creatorcontrib>Braschi, Caitlyn</creatorcontrib><creatorcontrib>de Virgilio, Christian M.</creatorcontrib><creatorcontrib>Ozao-Choy, Junko</creatorcontrib><creatorcontrib>Kim, Dennis Y.</creatorcontrib><creatorcontrib>Moazzez, Ashkan</creatorcontrib><title>Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis</title><title>The American surgeon</title><description>Introduction
While literature widely supports early cholecystectomy for mild gallstone pancreatitis (GSP), this has not been reflected in clinical practice. Early cholecystectomy for GSP with end organ dysfunction remains controversial.
Objective
This study aims to evaluate the rate and outcomes of early cholecystectomy (<3 days from admission) in mild GSP patients with end organ dysfunction (+EOD) and without (–EOD).
Methods
Patients with GSP without necrosis were identified from 2017 to 2019 NSQIP database and categorized into GSP±EOD. Coarsened Exact Matching was used to match patients based on preoperative risk factors in each group, and outcomes were compared.
Results
There was a total of 3104 patients –EOD and 917 +EOD in the aggregate cohort. Early cholecystectomy was performed in 1520 (49.0%) of GSP-EOD and in 407 (44.4%) of GSP+EOD. In the matched cohorts, there were no significant differences in 30-day mortality, morbidity, or reoperation for early cholecystectomy in either group. In GSP-EOD, early cholecystectomy was associated with shorter LOS (2.9 ± 1.5 vs. 5.6 ± 3.0 days, P < .001), shorter operative time (69.7 ± 34.4 vs. 73.3 ± 36.6 min, P = .045), and more concurrent biliary procedures (52.1% vs. 35.4%, P < .001). Similarly, early cholecystectomy in GSP+EOD was associated with shorter LOS (3.3 ± 1.8 vs. 6.9 ± 6.6 days, P < .001), shorter operative time (65.9 ± 32.1 vs. 76.0 ± 40.7, P < .001), and more concurrent biliary procedure (46.0% vs. 34.9%, P = .002).
Conclusions
This study supports early cholecystectomy in patients with mild GSP. Even with end organ dysfunction, early cholecystectomy appears to be safe given there is no difference in morbidity and mortality, and the potential benefit of reduced LOS.</description><subject>Ascites</subject><subject>Body mass index</subject><subject>Calculi</subject><subject>Cholecystectomy</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Diabetes</subject><subject>Dyspnea</subject><subject>Gallstones</subject><subject>Heart failure</subject><subject>Hispanic people</subject><subject>Hypertension</subject><subject>Kidneys</subject><subject>Laparoscopy</subject><subject>Length of stay</subject><subject>Medical personnel</subject><subject>Metastasis</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Necrosis</subject><subject>Pancreatitis</subject><subject>Patients</subject><subject>Quality improvement</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sepsis</subject><subject>Steroids</subject><subject>Ventilators</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp1kU9rGzEQxUVJoE7SD9CboJdcNtVoV9YqN-M4f8DULm3pcZmVtYnMWrIl7WG_feS4UGjoad4wv_cYZgj5DOwGQMqvjLESyqrmHICpqq4_kAkIIQpV8_KMTI7z4gh8JBcxbnNbTQVMyGGBoR_p_MX3Ro8xGZ38bqTW0Qfs-5i8M3SNTgeDySYbc5OscSnS3za9UHSbN-GHRBdZr8IzOno3xm5wOlnvbumMfvv-42lNZw77Mdp4Rc477KP59Kdekl_3i5_zx2K5eniaz5aFLqFOxUYbBVhLaTjrALFqS10JVTPW5hHjnKNUElAo6LCDjleqFa3krRK8BbUpL8n1KXcf_GEwMTU7G7Xpe3TGD7Hh03ysKSsrldEv_6BbP4S8b6ZkhiQTqswUnCgdfIzBdM0-2B2GsQHWHJ_QvHtC9tycPBGfzd_U_xteASX8hjk</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Liu, Jessica K.</creator><creator>Braschi, Caitlyn</creator><creator>de Virgilio, Christian M.</creator><creator>Ozao-Choy, Junko</creator><creator>Kim, Dennis Y.</creator><creator>Moazzez, Ashkan</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7T7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4321-9734</orcidid><orcidid>https://orcid.org/0000-0003-2706-746X</orcidid></search><sort><creationdate>202210</creationdate><title>Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis</title><author>Liu, Jessica K. ; Braschi, Caitlyn ; de Virgilio, Christian M. ; Ozao-Choy, Junko ; Kim, Dennis Y. ; Moazzez, Ashkan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c318t-dce91a877e20f1aa4b3c459800bdce0222a7971a591faf1f249b5b72b952b19d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Ascites</topic><topic>Body mass index</topic><topic>Calculi</topic><topic>Cholecystectomy</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Diabetes</topic><topic>Dyspnea</topic><topic>Gallstones</topic><topic>Heart failure</topic><topic>Hispanic people</topic><topic>Hypertension</topic><topic>Kidneys</topic><topic>Laparoscopy</topic><topic>Length of stay</topic><topic>Medical personnel</topic><topic>Metastasis</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Necrosis</topic><topic>Pancreatitis</topic><topic>Patients</topic><topic>Quality improvement</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Sepsis</topic><topic>Steroids</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Jessica K.</creatorcontrib><creatorcontrib>Braschi, Caitlyn</creatorcontrib><creatorcontrib>de Virgilio, Christian M.</creatorcontrib><creatorcontrib>Ozao-Choy, Junko</creatorcontrib><creatorcontrib>Kim, Dennis Y.</creatorcontrib><creatorcontrib>Moazzez, Ashkan</creatorcontrib><collection>SAGE Journals</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Jessica K.</au><au>Braschi, Caitlyn</au><au>de Virgilio, Christian M.</au><au>Ozao-Choy, Junko</au><au>Kim, Dennis Y.</au><au>Moazzez, Ashkan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis</atitle><jtitle>The American surgeon</jtitle><date>2022-10</date><risdate>2022</risdate><volume>88</volume><issue>10</issue><spage>2579</spage><epage>2583</epage><pages>2579-2583</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Introduction
While literature widely supports early cholecystectomy for mild gallstone pancreatitis (GSP), this has not been reflected in clinical practice. Early cholecystectomy for GSP with end organ dysfunction remains controversial.
Objective
This study aims to evaluate the rate and outcomes of early cholecystectomy (<3 days from admission) in mild GSP patients with end organ dysfunction (+EOD) and without (–EOD).
Methods
Patients with GSP without necrosis were identified from 2017 to 2019 NSQIP database and categorized into GSP±EOD. Coarsened Exact Matching was used to match patients based on preoperative risk factors in each group, and outcomes were compared.
Results
There was a total of 3104 patients –EOD and 917 +EOD in the aggregate cohort. Early cholecystectomy was performed in 1520 (49.0%) of GSP-EOD and in 407 (44.4%) of GSP+EOD. In the matched cohorts, there were no significant differences in 30-day mortality, morbidity, or reoperation for early cholecystectomy in either group. In GSP-EOD, early cholecystectomy was associated with shorter LOS (2.9 ± 1.5 vs. 5.6 ± 3.0 days, P < .001), shorter operative time (69.7 ± 34.4 vs. 73.3 ± 36.6 min, P = .045), and more concurrent biliary procedures (52.1% vs. 35.4%, P < .001). Similarly, early cholecystectomy in GSP+EOD was associated with shorter LOS (3.3 ± 1.8 vs. 6.9 ± 6.6 days, P < .001), shorter operative time (65.9 ± 32.1 vs. 76.0 ± 40.7, P < .001), and more concurrent biliary procedure (46.0% vs. 34.9%, P = .002).
Conclusions
This study supports early cholecystectomy in patients with mild GSP. Even with end organ dysfunction, early cholecystectomy appears to be safe given there is no difference in morbidity and mortality, and the potential benefit of reduced LOS.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><doi>10.1177/00031348221109488</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-4321-9734</orcidid><orcidid>https://orcid.org/0000-0003-2706-746X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Ascites Body mass index Calculi Cholecystectomy Chronic obstructive pulmonary disease Diabetes Dyspnea Gallstones Heart failure Hispanic people Hypertension Kidneys Laparoscopy Length of stay Medical personnel Metastasis Morbidity Mortality Necrosis Pancreatitis Patients Quality improvement Risk analysis Risk factors Sepsis Steroids Ventilators |
| title | Early Cholecystectomy in Gallstone Pancreatitis Patients With and Without End Organ Dysfunction: A NQSIP Analysis |
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