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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 | 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 |
| 3 | 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 |
| 4 | 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 |
| 5 | 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 |
| 6 | Material and process limits of silicon VLSI technology显示文摘 | PLUMMER J D GRIFFIN P B | 2001 | Proc IEEE2001，89，3： | 1 |
| 7 | 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 |
| 8 | The acid hydrolysis of sugarcane bagasse hemicellulose to produce xylose,arabinose,glucose and other products 显示文摘 | Lavarack B P Griffin G J Rodman D | 2002 | Biomass and Bioenergy2002，23，： | 1 |
| 9 | The acid hydrolysis of sugarcane bagasse hemiceUulose to produce xylose, arabinose, glucose and other products显示文摘 | Lavarack B P Griffin G J Rodman D | 2002 | Biomass and Bioenergy2002，23，： | 1 |
| 10 | 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 | 2005 | J Bone Joint Surg Br2005，87，10： | 1 |
| 11 | Pressure and Temperature Effects in Bituminous Coal Pyrolysis:Experimental Observations and a Transient lumped-parameter Model显示文摘 | Griffin T P Howard J B Peters W A | 1994 | Fuel1994，73，4： | 1 |
| 12 | Ecteinascidin 743 inter- feres with the activity of EWS-FLI1 in Ewing sarcoma cells显示文摘 | Grohar P J Griffin L B Yeung C | 2011 | Neoplasia2011，13，2： | 1 |
| 13 | Predictors of hemolytic uremic syndrome in children during a large outbreak of Escherichia coli O157:H7 infections显示文摘 | BELL B P GRIFFIN P M LOZANO P | 1997 | Pediatrics1997，100，1： | 1 |
| 14 | Homologous recombination deficiency leads to profound genetic instability in cells derived from XRCC2-knockout mice显示文摘 | Deans B Griffin CS O'Regan P | 2003 | Cancer Res2003，63，： | 1 |
| 15 | Monoelonal antibody-based competitive assay for the sensitive detection of coeliac disease toxic prolamins显示文摘 | Bermudo Redondo M C Griffin P B Garzon Ransanz M | | 0，，1： | 1 |
| 16 | Homologous recombination deficiency leads to profound genetic instability in cells derived from XRCC2-knockout mice显示文摘 | DEANS B GRIFFIN C S O'REGAN P | 2003 | Cancer Res2003，63，23： | 1 |
| 17 | An experimental and modeling study of heating rate and particle size effects in bituminous coal pyrolysis显示文摘 | Griffin T P Howard J B Peters W A | 1993 | Energy & fu- els1993，7，2： | 1 |
| 18 | The acid hydrzlysis of sugarcane bagasse hemicellulose to produce xylose, arabinose, glucose and other products显示文摘 | LAVARACK B P GRIFFIN G J RODMAN D | 2002 | Biomass and Bioenergy2002，23，5： | 1 |
| 19 | Mineral chemistry and zircon geochronology of xenocrysts and altered mantle and crustal xenoliths from the Aries micaceous kimberlite:constraints on the composition and age of the central Kimberley Craton,Western Australia显示文摘 | DOWNES P J GRIFFIN B J GRIFFIN W L | 2007 | Lithos2007，93，12： | 1 |
| 20 | The acid hydrolysisof sugarcane bagasse hemicellulose to produce xylose, arabinose, glucose and product显示文摘 | Lavarack B P Griffin G J Rodman D | 2002 | Biomass and Bioenergy2002，23，： | 1 |
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