Imperial College London
Alternate

ProfessorGeorgeHanna

Faculty of Medicine, Department of Surgery & Cancer

Head of Department of Surgery and Cancer
 
 
 
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Contact

 

+44 (0)20 7594 3396g.hanna

 
 
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Assistant

 

Ms Aoibheann Byrne +44 (0)20 7594 3396

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wiggins:2019:10.1007/s00464-018-6537-x,
author = {Wiggins, T and Markar, SR and MacKenzie, H and Faiz, O and Mukherjee, D and Khoo, DE and Purkayastha, S and Beckingham, I and Hanna, GB},
doi = {10.1007/s00464-018-6537-x},
journal = {SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES},
pages = {2495--2502},
title = {Optimum timing of emergency cholecystectomy for acute cholecystitis in England: population-based cohort study},
url = {http://dx.doi.org/10.1007/s00464-018-6537-x},
volume = {33},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundCholecystectomy on index admission for acute cholecystitis is associated with improved patient outcomes. The timing of intervention is mainly driven by service provision. This population-based cohort study aimed to evaluate timing of emergency cholecystectomy in England.MethodsData from all consecutive patients undergoing surgery for acute cholecystitis on index admission in England from 1997 to 2012 were captured from the Hospital Episodes Statistics database. Data were analysed based on whether patients underwent surgery 0–3 days, 4–7 days or ≥ 8 days from admission. Outcome measures were rate of post-operative biliary complications, conversion to open and length of stay.ResultsForty-three thousand eight hundred and seventy patients underwent emergency cholecystectomy. 64.6% of patients underwent surgery between days 0 and 3 of admission, 24.3% between days 4–7 and 11.0% had surgery after day 8. Patients undergoing early surgery had significantly reduced rates of intra-operative laparoscopic conversion to open (0–3 days: 3.6%; 4–7 days: 4.0%; ≥ 8 days 4.7%, p = 0.001), post-operative ERCP (0–3 days: 1.1%; 4–7 days: 1.5%; ≥ 8 days 1.9%, p < 0.001) and bile duct injury (0–3 days: 0.6%; 4–7 days: 1.0%; ≥ 8 days 1.8%, p < 0.001). Early cholecystectomy was also associated with a shorter post-operative length of stay (LOS) [0–3 days group: median post-operative LOS 3 days (IQR: 1–6); 4–7 days group: 3 days (IQR 2–6); ≥ 8 days group: 4 days (IQR 2–9) (p < 0.001)]. High-volume centres undertook a significantly greater proportion of cholecystectomies within 3 days of presentation (high-volume: 67.3%; medium-volume: 64.8%; low-volume: 61.2%). In multivariate analysis greater time to surgery was independently associated with increased risk of post-operative ERCP and bil
AU  - Wiggins,T
AU  - Markar,SR
AU  - MacKenzie,H
AU  - Faiz,O
AU  - Mukherjee,D
AU  - Khoo,DE
AU  - Purkayastha,S
AU  - Beckingham,I
AU  - Hanna,GB
DO  - 10.1007/s00464-018-6537-x
EP  - 2502
PY  - 2019///
SN  - 0930-2794
SP  - 2495
TI  - Optimum timing of emergency cholecystectomy for acute cholecystitis in England: population-based cohort study
T2  - SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
UR  - http://dx.doi.org/10.1007/s00464-018-6537-x
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000475988800013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/72329
VL  - 33
ER  -
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