Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov;97(8):568-73.
doi: 10.1308/rcsann.2015.0035.

Acute surgical unit safely reduces unnecessary after-hours cholecystectomy

T S Suhardja  1 , L Bae  1 , E Z Seah  1 , P Cashin  1 , D G Croagh  1
Affiliations

Acute surgical unit safely reduces unnecessary after-hours cholecystectomy

T S Suhardja et al. Ann R Coll Surg Engl. 2015 Nov.

Abstract

Introduction: The acute surgical model has been trialled in several institutions with mixed results. The aim of this study was to determine whether the acute surgical model provides better outcomes for patients with acute biliary presentation, compared with the traditional emergency surgery model of care.

Methods: A retrospective review was carried out of patients who were admitted for management of acute biliary presentation, before and after the establishment of an acute surgical unit (ASU). Outcomes measured were time to operation, operating time, after-hours operation (6pm - 8am), length of stay and surgical complications.

Results: A total of 342 patients presented with acute biliary symptoms and were managed operatively. The median time to operation was significantly reduced in the ASU group (32.4 vs 25.4 hours, p=0.047), as were the proportion of operations performed after hours (19.5% vs 2.5%, p<0.001) and the median length of stay (4 vs 3 days, p<0.001). The median operating time, rate of conversion to open cholecystectomy and wound infection rates remained similar.

Conclusions: Implementation of an ASU can lead to objective differences in outcomes for patients who present with acute cholecystitis. In our study, the ASU significantly reduced time to operation, the number of operations performed after hours and length of stay.

Keywords: Cholecystectomy; Cholecystitis; Gallbladder diseases; General surgery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of study population with exclusion criteria
Figure 2
Figure 2
Number of operations at particular hours of the day
See this image and copyright information in PMC

References

    1. Earley AS, Pryor JP, Kim PK. et al. . An acute care surgery model improves outcomes in patients with appendicitis. Ann Surg 2006; : 498–504. - PMC - PubMed
    1. Ekeh AP, Monson B, Wozniak CJ. et al. . Management of acute appendicitis by an acute care surgery service: is operative intervention timely? J Am Coll Surg 2008; : 43–48. - PubMed
    1. Parasyn AD, Truskett PG, Bennett M. et al. . Acute-care surgical service: a change in culture. ANZ J Surg 2009; : 12–18. - PubMed
    1. Lehane CW, Jootun RN, Bennett M. et al. . Does an acute care surgical model improve the management and outcome of acute cholecystitis? ANZ J Surg 2010; : 438–442. - PubMed
    1. Cox MR, Cook L, Dobson J. et al. . Acute Surgical Unit: a new model of care. ANZ J Surg 2010; : 419–424. - PubMed

LinkOut - more resources