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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 | Spontaneous ignition of pressurized releases of hydrogen and natural gas into air 显示文摘 | DRYER F L CHAOS M ZHAO Z W | 2007 | Combustion Science and Technology2007，179，4： | 1 |
| 3 | Use of a long-acting gonadotropin-releasing hormone agonist for treatment of steroid cell tumors ofthe ovary显示文摘 | Wang P H Chao H T Lee W L | 1998 | Fertil Steri1998，69，2： | 1 |
| 4 | Vibration of thick rectangular plates of bimodulous composite material显示文摘 | Bert C W Reddy J N Chao W C | 1981 | Journal of Applied Mechanics1981，48，2： | 1 |
| 5 | Neuroprotective effect of osthole against oxygen andglucose deprivation in rat cortical neurons:involvementof mitogen-activated protein kinase pathway显示文摘 | Chen T Liu W Chao X Qu Y Zhang L Luo P | 2011 | Neuro-science2011，183，： | 1 |
| 6 | Real-time dwell scheduling of component oriented phased array radars显示文摘 | KuoT W Chao Y S Kuo C F | 2005 | IEEE Transactions on Computers2005，54，1： | 1 |
| 7 | On tracking the source location of voltage sags and utility shunt capacitor switching transients显示文摘 | Chang G W Chao Jupeng Huang H M | 2008 | IEEE Trans on Power Delivery2008，23，4： | 1 |
| 8 | Human tissue kallikrein induces hypotension in transgenic mice显示文摘 | Wang J Xiong W Yang Z Davis T Dewey MJ Chao J | 1994 | Hypertension1994，23，： | 1 |
| 9 | Porcine model of congenital heart defect with decreased pulmonary blood flow 显示文摘 | Xuegang L Chao S Kangwu W | 2011 | Cell Biochem Biophys2011，61，3： | 1 |
| 10 | A pro-drug of the green tea polyphenol (-)-epigallocatechin-3-gallate(EGCG) prevents differenti- ated SH-SY5Y cells from toxicity induced by 6-hydroxydopamine显示文摘 | CHAO Jianfei LAU W K W HUIE M J | 2010 | Neuroseience Letters2010，469，3： | 1 |
| 11 | Characterisation of gas phase organic emissions from hot cooking oil in commercial kitchens 显示文摘 | To W M Yeung L L Chao C Y H | 2002 | Indoor Built Environment2002，9，： | 1 |
| 12 | Knowing when to grow:signals regulating bud dormancy显示文摘 | HORVATH D P ANDERSON J V CHAO W S FOLEY M E | 2003 | Trends in Plant Science2003，8，： | 1 |
| 13 | Human umbilical cord mesenchymal stem cells suppress breast cancer tumouri- genesis through direct cell-cell contact and internalization 显示文摘 | Chao K C Yang H T Chen M W | 2012 | J Cell Mol Med2012，16，8： | 1 |
| 14 | Receptor- Mediated Self - Assembly of Multi - Component Magnetic Nanowires显示文摘 | Salem A K Chao J Leong K W Searson P C | 2004 | Advanced Materials2004，16，3： | 1 |
| 15 | A Long Intrudingly Investigation of New Comer Expectations, Early Socialization out Comes, and Than Overrating Effects Froe Development factors 显示文摘 | Major D A Kozlowski S W J Chao G | 1995 | Journal of Applied Psychology1995，80，3： | 1 |
| 16 | Heat Transfer in Friction Stir Welding- Experimental and Numerical Studies 显示文摘 | Yuh J Chao X Qi W Tang | 2003 | Transactions of the ASME Journal of Manufacturing Science end Engineering (S1087-1357)2003，125，1： | 1 |
| 17 | Expression of P2X purinoceptnrs during rat brain development and their inhihitory role on motor axon outgrowth in neural tube explant cultures 显示文摘 | Cheung K K Chao W Y Burnstoek G | 2005 | Neuroscience2005，133，4： | 1 |
| 18 | Toll-like receptor signaling: a critical modulator of cell survival and ischemic injury in the heart显示文摘 | Chao W | 2009 | Am J Physiol Heart Circ Physio12009，296，1： | 1 |
| 19 | p53 regulates epithelial- mesenchymal transition and stem cell properties through modulating miRNAs 显示文摘 | Chang CJ Chao CH Xia W | 2011 | Nat Cell Biol2011，13，3： | 1 |
| 20 | Reduction of the particulate and nitric oxide from the diesel engine using a plasma chemical hybrid显示文摘 | Chao J O Hwang J W Jung J Y | 2001 | Physics of Plasmas2001，8，14： | 1 |
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