Anjum G.A.; Skouras T.; Longley C.; Liu L.S.; Rathe S.; Khan U.A; International Journal of Surgery, 2013,

Day case laparoscopic cholecystectomy: A DGH experience, can a national average target be achieved?
International Journal of Surgery, 2013, vol./is. 11/8(648-649), 1743-9191
Author(s): Anjum G.A.; Skouras T.; Longley C.; Liu L.S.; Rathe S.; Khan U.A.
Language: English

Aim: To evaluate our current practice of Cholecystectomy in terms of number of Day Case Cholecystectomies (DCLC) and re-admissions as compared to National Average, to improve the outcome.

Methods: A retrospective audit from 01/09/2010 to 31/08/2011. All patients who underwent cholecystectomy at DGH Macclesfield, were included in the study. Data was extracted from case notes and electronic discharge summaries, entered to a Performa and was analysed using Microsoft Excel. No exclusion criteria.

Results:  Out of 194, 90.7% were operated laparoscopically, 36% as day case, 43% as 23 hour stay (total 79%)and 21% as inpatient. Average length of stay for all laparoscopic cholecystectomies was 1.21 days. Number of DCLCs varied from 14% to 55% among surgical teams. 10.3% of patients readmitted to the hospital within 29 days of index surgery with intra-abdominal collection, wound infection, pancreatitis and cholangitis in descending order. Conclusion: The high performing team (in number) had highest number of DCLCs (55%). Our readmission rates were comparable to the National Average.

National Average targets for DCLC can be achieved at relatively smaller organizations like DG Hospitals provided that Cholecystectomy is considered as a Day Case procedure by default and clear criteria for patient selection are established and implemented.

Publication Type: Journal: Conference Abstract
Source: EMBASE

Case Report: Symptomatic cholecystolithiasis after cholecystectomy

BMJ Case Reports 2013; doi:10.1136/bcr-2012-007692

Symptomatic cholecystolithiasis after cholecystectomy

A 43-year-old woman was admitted to the gastroenterology department with colicky pain in the upper abdomen. Four years earlier, she had undergone a laparoscopic cholecystectomy because of cholecystitis. She recognised her current complaints from that previous episode. An endoscopic retrograde cholangiopancreatography showed a cavity with a diameter of 2 cm which contained multiple concrements near the liver hilus. An elective surgical exploration was performed. Near the clip of the previous cholecystectomy a bulging of the biliary tract with its own duct was visualised and resected. Histological examination of this “neo” gallbladder showed that the bulging was consistent with the formation of a reservoir secondary to bile leakage, probably caused by a small peroperative lesion of the common bile duct during the previous cholecystectomy. In conclusion, our patient presented with colicky pain caused by concrements inside a ‘neo’ gallbladder.

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