PWE-438 Cholecystectomy audit: waiting time, readmissions and complications

Gill, Eric W.; Doherty, Catherine; Veitch, Jessica; Brett, Martin

doi:10.1136/gutjnl-2015-309861.884

Cited by 5 publications

(5 citation statements)

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“…The evidence from most studies is sufficient to support their results [ 10 , 28 , 32 , 34 , 35 , 37 , 42 , 43 ]. However, one study demonstrated poor study methodology because confounding factors were not considered when recruiting study participants or in the data analysis [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

Patient prioritisation methods to shorten waiting times for elective surgery: A systematic review of how to improve access to surgery

2021

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Background Concern about long waiting times for elective surgeries is not a recent phenomenon, but it has been heightened by the impact of the COVID-19 pandemic and its associated measures. One way to alleviate the problem might be to use prioritisation methods for patients on the waiting list and a wide range of research is available on such methods. However, significant variations and inconsistencies have been reported in prioritisation protocols from various specialties, institutions, and health systems. To bridge the evidence gap in existing literature, this comprehensive systematic review will synthesise global evidence on policy strategies with a unique insight to patient prioritisation methods to reduce waiting times for elective surgeries. This will provide evidence that might help with the tremendous burden of surgical disease that is now apparent in many countries because of operations that were delayed or cancelled due to the COVID-19 pandemic and inform policy for sustainable healthcare management systems. Methods We searched PubMed, EMBASE, SCOPUS, Web of Science, and the Cochrane Library, with our most recent searches in January 2020. Articles published after 2013 on major elective surgery lists of adult patients were eligible, but cancer and cancer-related surgeries were excluded. Both randomised and non-randomised studies were eligible and the quality of studies was assessed with ROBINS-I and CASP tools. We registered the review in PROSPERO (CRD42019158455) and reported it in accordance with the PRISMA statement. Results The electronic search in five bibliographic databases yielded 7543 records (PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane) and 17 eligible articles were identified in the screening. There were four quasi-experimental studies, 11 observational studies and two systematic reviews. These demonstrated moderate to low risk of bias in their research methods. Three studies tested generic approaches using common prioritisation systems for all elective surgeries in common. The other studies assessed specific prioritisation approaches for re-ordering the waiting list for a particular surgical specialty. Conclusions Explicit prioritisation tools with a standardised scoring system based on clear evidence-based criteria are likely to reduce waiting times and improve equitable access to health care. Multiple attributes need to be considered in defining a fair prioritisation system to overcome limitations with local variations and discriminations. Collating evidence from a diverse body of research provides a single framework to improve the quality and efficiency of elective surgical care provision in a variety of health settings. Universal prioritisation tools with vertical and horizontal equity would help with re-ordering patients on waiting lists for elective surgery and reduce waiting times.

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Section: Resultsmentioning

confidence: 99%

Patient prioritisation methods to shorten waiting times for elective surgery: A systematic review of how to improve access to surgery

2021

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“…The evidence from most studies is sufficient to support their results (10, 27, 31, 33, 34, 36, 41, 42). However, one study demonstrated poor study methodology because confounding factors were not considered when recruiting study participants or in the data analysis (43).…”

Section: Resultsmentioning

confidence: 99%

Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

Rathnayake

Clarke²,

Jayasinghe

2021

Preprint

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Background: Concern about long waiting times for elective surgeries is not a recent phenomenon, but it has been heightened by the impact of the COVID-19 pandemic and its associated measures. One way to alleviate the problem might be to use prioritisation methods for patients on the waiting list and a wide range of research is available on such methods. However, significant variations and inconsistencies have been reported in prioritisation protocols from various specialties, institutions, and health systems. To bridge the evidence gap in existing literature, this comprehensive systematic review will synthesise global evidence on policy strategies with a unique insight to patient prioritisation methods to reduce waiting times for elective surgeries. This will provide evidence that might help with the tremendous burden of surgical disease that is now apparent in many countries because of operations that were delayed or cancelled due to the COVID-19 pandemic and inform policy for sustainable healthcare management systems. Methods: We searched PubMed, EMBASE, SCOPUS, Web of Science, and the Cochrane Library, with our most recent searches in January 2020. Articles published after 2013 on major elective surgery lists of adult patients were eligible, but cancer and cancer-related surgeries were excluded. Both randomised and non-randomised studies were eligible and the quality of studies was assessed with ROBINS-I and CASP tools. We registered the review in PROSPERO (CRD42019158455) and reported it in accordance with the PRISMA statement. Results: The electronic search in five bibliographic databases yielded 7543 records (PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane) and 17 eligible articles were identified in the screening. There were four quasi-experimental studies, 11 observational studies and two systematic reviews. These demonstrated a moderate to low risk of bias in their research methods. Three studies tested generic approaches using common prioritisation systems for all elective surgeries in common. The other studies assessed specific prioritisation approaches for re-ordering the waiting list for a particular surgical specialty. Conclusions: Explicit prioritisation tools with a standardised scoring system based on clear evidence-based criteria are likely to reduce waiting times and improve equitable access to health care. Multiple attributes need to be considered in defining a fair prioritisation system to overcome limitations with local variations and discriminations. Collating evidence from a diverse body of research provides a single framework to improve the quality and efficiency of elective surgical care provision in a variety of health settings. Universal prioritisation tools with vertical and horizontal equity would help with re-ordering patients on waiting lists for elective surgery and reduce waiting times. Keywords: Patient prioritisation, elective surgery, waiting time, systematic review

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“…The European Society of Gastrointestinal Endoscopy recommends performing laparoscopic cholecystectomy within 2 weeks from ERCP to minimize adverse events and surgical conversion rates [17] . Even before COVID-19, this interval was often overstepped [26] , [27] , [28] . In the ongoing pandemic, plannable surgeries for benign diseases have regularly been de-prioritized, further extending waiting times for cholecystectomies [29] .…”

Section: Discussionmentioning

confidence: 99%

“…A corresponding picture was painted in our dataset, with the recommended time window only being adhered to for a fraction of patients. This contraction of surgical capacity puts patients with cholelithiasis at risk of recurrent biliary obstruction and, subsequently, cholangitis, cholecystitis or pancreatitis [26 , [29] , [30] , [31] . Evidence is increasing that temporary stenting of the common bile duct could prove to be a viable remedy: (a) It is already established for initially irretrievable biliary stones as bridging to bile duct clearance [1 , 17 , 31 , 32] , (b) long-term stenting has repeatedly been discussed as an option for patients unfit for elective surgical procedures [32] , [33] , [34] , and (c) a recent randomized, controlled clinical trial for stenting as bridging to cholecystectomy in severe biliary pancreatitis showed a statistically significant reduction of recurrent biliary events [19] .…”

Section: Discussionmentioning

confidence: 99%

Biodegradable biliopancreatic stents could help conserve health care resources during the COVID-19 pandemic: An observational multicenter study

Maieron¹,

Erhart²,

Pramhofer³

et al. 2023

Digestive and Liver Disease

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PWE-438 Cholecystectomy audit: waiting time, readmissions and complications

Cited by 5 publications

References 0 publications

Patient prioritisation methods to shorten waiting times for elective surgery: A systematic review of how to improve access to surgery

Patient prioritisation methods to shorten waiting times for elective surgery: A systematic review of how to improve access to surgery

Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

Biodegradable biliopancreatic stents could help conserve health care resources during the COVID-19 pandemic: An observational multicenter study

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