Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20486
Full metadata record
DC FieldValueLanguage
dc.contributor.authorCox, Daniel R A-
dc.contributor.authorFong, Jonathan-
dc.contributor.authorLiew, Chon Hann-
dc.contributor.authorGoh, Su Kah-
dc.contributor.authorYeoh, Michael-
dc.contributor.authorFink, Michael A-
dc.contributor.authorJones, Robert M-
dc.contributor.authorMukkadayil, Jude-
dc.contributor.authorNikfarjam, Mehrdad-
dc.contributor.authorPerini, Marcos V-
dc.contributor.authorRumler, Greg-
dc.contributor.authorStarkey, Graham M-
dc.contributor.authorChristophi, Christopher-
dc.contributor.authorMuralidharan, Vijayaragavan-
dc.date.accessioned2019-03-20T05:23:59Z-
dc.date.available2019-03-20T05:23:59Z-
dc.date.issued2018-11-09-
dc.identifier.citationANZ Journal of Surgery 2018; 88 (12): 1337-1342en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/20486-
dc.description.abstractBACKGROUND: Acute biliary pain is the most common presentation of gallstone disease. Untreated patients risk recurrent pain, cholecystitis, obstructive jaundice, pancreatitis and multiple hospital presentations. We examine the outcome of implementing a policy to offer laparoscopic cholecystectomy on index presentation to patients with biliary colic in a tertiary hospital in Australia. METHODS: This is a retrospective cohort study of adult patients presenting to the emergency department (ED) with biliary pain during three 12-month periods. Outcomes in Group A, 3 years prior to policy implementation, were compared with groups 2 and 7 years post implementation (Groups B and C). Primary outcomes were representations to ED, admission rate and time to cholecystectomy. RESULTS: A total of 584 patients presented with biliary colic during the three study periods. Of these, 391 underwent cholecystectomy with three Strasberg Type A bile leaks and no bile duct injuries. The policy increased admission rates (A = 15.8%, B = 62.9%, C = 29.5%, P < 0.001) and surgery on index presentation (A = 12.0%, B = 60.7%, C = 27.4%, P < 0.001). There was a decline in time to cholecystectomy (days) (A = 143, B = 15, C = 31, P < 0.001), post-operative length of stay (days) (A = 3.6, B = 3.2, C = 2.0, P < 0.05) and representation rates to ED (A = 42.1%, B = 7.1%, C = 19.9%, P < 0.001). There was a decline in policy adherence in the later cohort. CONCLUSION: Index hospital admission and cholecystectomy for biliary colic decrease patient representations, time to surgery, post-operative stay and complications of gallstone disease. This study demonstrates the impact of the policy with initial improvement, the dangers of policy attrition and the need for continued reinforcement.en_US
dc.titleEmergency presentations of acute biliary pain: changing patterns of management in a tertiary institute.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleANZ Journal of Surgeryen_US
dc.identifier.affiliationAustin Healthen_US
dc.identifier.affiliationDepartment of Hepato-Pancreatic-Biliary Surgery, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationSurgery (University of Melbourne)en_US
dc.identifier.affiliationEmergencyen_US
dc.identifier.affiliationVictorian Liver Transplant Uniten_US
dc.type.studyortrialCohort Studyen_US
dc.identifier.doi10.1111/ans.14898en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-5092-4370en_US
dc.identifier.orcid0000-0002-0165-1564en_US
dc.identifier.orcid0000-0002-6684-2521en_US
dc.identifier.pubmedid30414227-
dc.type.austinJournal Articleen_US
local.name.researcherChristophi, Christopher
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
crisitem.author.deptVascular Surgery-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptSurgery-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptHepatopancreatobiliary Surgery-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptHepatopancreatobiliary Surgery-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptSurgery-
crisitem.author.deptHepatopancreatobiliary Surgery-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptHepatopancreatobiliary Surgery-
crisitem.author.deptSurgery-
Appears in Collections:Journal articles
Show simple item record

Page view(s)

40
checked on Mar 28, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.