Surgeon Volume Metrics in Laparoscopic Cholecystectomy

Csikesz, Nicholas G.; Singla, Anand; Murphy, Melissa M.; Tseng, Jennifer F.; Shah, Shimul A.

doi:10.1007/s10620-009-1035-6

Cited by 119 publications

(68 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Accordingly, the increase in minimally invasive surgeries (e.g., laparascopic cholecystectomy) is consistent with the marked decrease in abdominal surgeries requiring an overnight stay. 27 The median time to the start of dialysis decreased during the study period, from five days to two days after surgery. Patients with preoperative chronic kidney disease are among those at highest risk for acute kidney injury, and the proportion of these patients having major surgery increased with time.…”

Section: Discussionmentioning

confidence: 91%

Secular trends in acute dialysis after elective major surgery — 1995 to 2009

Siddiqui

Coca

Devereaux

et al. 2012

CMAJ

119

116

View full text Add to dashboard Cite

Research CMAJBackground: Acute kidney injury is a serious complication of elective major surgery. Acute dialysis is used to support life in the most severe cases. We examined whether rates and outcomes of acute dialysis after elective major surgery have changed over time. Methods:We used data from Ontario's universal health care databases to study all consecutive patients who had elective major surgery at 118 hospitals between 1995 and 2009. Our primary outcomes were acute dialysis within 14 days of surgery, death within 90 days of surgery and chronic dialysis for patients who did not recover kidney function.Results: A total of 552 672 patients underwent elective major surgery during the study period, 2231 of whom received acute dialysis. The incidence of acute dialysis increased steadily from 0.2% in 1995 (95% confidence interval [CI] 0.15-0.2) to 0.6% in 2009 (95% CI 0.6-0.7). This increase was primarily in cardiac and vascular surgeries. Among patients who received acute dialysis, 937 died within 90 days of surgery (42.0%, 95% CI 40.0-44.1), with no change in 90-day survival over time. Among the 1294 patients who received acute dialysis and survived beyond 90 days, 352 required chronic dialysis (27.2%, 95% CI 24.8-29.7), with no change over time.Interpretation: The use of acute dialysis after cardiac and vascular surgery has increased substantially since 1995. Studies focusing on interventions to better prevent and treat perioperative acute kidney injury are needed. Abstract

show abstract

Section: Discussionmentioning

confidence: 91%

Secular trends in acute dialysis after elective major surgery — 1995 to 2009

Siddiqui

Coca

Devereaux

et al. 2012

CMAJ

119

116

View full text Add to dashboard Cite

show abstract

“…Surgeons' experience (junior vs. senior), case load, and risk-taking profile are reported to be of influence [3,6,21]. For acute cholecystitis, the relationship between volume and specialization has been the focus of recent research [6,11,24]. Improvement in conversion rates for emergency surgery and acute cholecystitis by assignment of patients to specialized or high-volume surgeons is suggested by these data.…”

Section: Discussionmentioning

confidence: 99%

“…The following patient and nonpatient factors have inconsistently been suggested as enlarging the risk for conversion: gender, age, body mass index (BMI), previous abdominal surgery, previous endoscopic retrograde cholangiography (ERC), acute cholecystitis, and equipment failure [2,3,12,20,30]. Surgeon experience and case load have been reported, but surgeon specialization has not been a well-studied topic to date [3,6,11,21,28,29].…”

mentioning

confidence: 99%

Outcome of laparoscopic cholecystectomy conversion: is the surgeon’s selection needed?

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Somewhat unexpected in our analysis is the finding that after two decades of experience, only an estimated 80 % of all cholecystectomies are performed laparoscopically. This number is lower than the expected, even in light of several recently published series estimating conversion rates to be around 10 % [14][15][16].…”

Section: Discussionmentioning

confidence: 56%

Major bile duct injury requiring operative reconstruction after laparoscopic cholecystectomy: a follow-on study

et al. 2015

View full text Add to dashboard Cite

LC continued to increase in utilization between 2001 and 2011. Although rates of BDI have decreased, the need for reconstruction continues to be associated with a significant mortality. In addition, mortality related to biliary reconstruction is also higher than previously published series and may reflect the complexity of managing biliary injury as well as the higher likelihood of these patients having comorbid conditions.

show abstract

Surgeon Volume Metrics in Laparoscopic Cholecystectomy

Abstract: Increasing surgical volume remains associated with improved outcomes after surgery during emergent/urgent admission for AC with fewer open conversions and prolonged LOS. Our results suggest that referral to HV surgeons has improved outcomes after LC for AC.

Cited by 119 publications

References 32 publications

Secular trends in acute dialysis after elective major surgery — 1995 to 2009

Secular trends in acute dialysis after elective major surgery — 1995 to 2009

Outcome of laparoscopic cholecystectomy conversion: is the surgeon’s selection needed?

Major bile duct injury requiring operative reconstruction after laparoscopic cholecystectomy: a follow-on study

Contact Info

Product

Resources

About