Fast-Track Nonelective Laparoscopic Cholecystectomy is Safe and Feasible

Fair, Lucas; Squiers, John J.; Jacinto, Kimberly; Perryman, Matthew; Misenhimer, Jennifer; Blair, Somer; Rodríguez, Carlos J.

doi:10.1016/j.jss.2022.09.003

Cited by 2 publications

(2 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Standardizing intraoperative process has been shown to support robust outcomes in laparoscopic cholecystectomy (LC), 8,9 while in elective biliary surgery, implementation of day stay protocols has been shown to significantly shorten length of stay (LOS) 10 . In the acute setting, enhanced recovery protocols have demonstrated early promise, reducing cost, and LOS without compromising patient care 11–14 . Further exploration of the factors impacting perioperative process and LOS can further inform the development of integrated perioperative management protocols.…”

Section: Introductionmentioning

confidence: 99%

“…10 In the acute setting, enhanced recovery protocols have demonstrated early promise, reducing cost, and LOS without compromising patient care. [11][12][13][14] Further exploration of the factors impacting perioperative process and LOS can further inform the development of integrated perioperative management protocols. Application of these in practice has the potential to mitigate the resource constraint that has manifested in reduced access to operative care, insufficient hospital beds, and increasingly stretched staff working in difficult clinical environments.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Standardizing process in acute biliary disease

Tranter‐Entwistle,

Eglinton,

Connor

2023

World j. surg.

View full text Add to dashboard Cite

IntroductionThe perioperative management of biliary disease (BD) is variable across institutions with suboptimal outcomes for patients and health care systems. This results in inefficient utilization of limited resources. The aim of the current study was to identify modifiable factors impacting patients' time to theater, intraoperative time, and time to discharge as the constituents of length of stay to guide creation of a perioperative management protocol to address this variability.MethodsData were prospectively captured at Christchurch Hospital for all adult patients presenting for cholecystectomy between May 2015 and May 2022. Pre, post, and intraoperative factors were assessed for their impact on time to theater, operative time, and postoperative hours to discharge.ResultsFour thousand five hundred seventy‐seven patients underwent cholecystectomy during the study period, of which 2807 (61%) were acute presentations and made up the cohort for analysis. Time to theater was significantly impacted by preoperative imaging type, while operative grade and the procedure type had the most clinically significant impact on operative time. Postoperatively time to discharge was significantly impacted by drain placement.ConclusionsStandardizing management of BD would likely result in significant savings for the health care system and improved outcomes for patients. The data seen here evidence the importance of appropriate imaging selection, intraoperative difficulty operative grade identification, and low suction drain selection. These data have been incorporated in a perioperative management protocol as standardization of care across the patient workflow in BD is a sensible approach for ensuring optimal use of scarce resources.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%