Variation in the practice of cholecystectomy for benign biliary disease in Aotearoa New Zealand: a population-based cohort study

被引：2

作者：

Varghese, Chris

McGuinness, Matthew

Wells, Cameron I.

Elliott, Brodie M.

Gunawardene, Ashok

Edwards, Melissa ^{[14
]}

Vohra, Ravinder

Griffiths, Ewen A.

Connor, Saxon ^{[4
]}

Poole, Garth H.

Windsor, John A.

Wright, Deborah

Harmston, Christopher ^{[11
]}

Wang, Jim Hsu-Shun ^{[1
]}

Windsor, John ^{[1
,2
]}

Chen, Elizabeth ^{[1
]}

Ghate, Kaustubha ^{[1
]}

Lal, Shayal ^{[1
]}

Lekamalage, Binura ^{[1
]}

Ratnayake, Milidu ^{[1
]}

Bansal, Arpita ^{[2
]}

Windsor, John ^{[1
,2
]}

von Keisenberg, Seagh ^{[2
]}

Hemachandran, Arthana ^{[2
]}

Singhal, Megan ^{[2
]}

Joseph, Nejo ^{[2
]}

Bhat, Sameer ^{[3
]}

Rossaak, Jeremy ^{[3
]}

Carson, Daniel ^{[3
]}

Dubey, Nandini ^{[3
]}

Pan, Marcus ^{[3
]}

Ferguson, Liam ^{[3
]}

Watt, Imogen ^{[3
]}

Choi, Jenny ^{[3
]}

Mclauchlan, Jared ^{[4
]}

Connor, Saxon ^{[4
]}

Nicholas, Ella ^{[4
]}

Al-Busaidi, Ibrahim ^{[4
]}

Wood, Douglas ^{[5
]}

Haran, Cheyaanthan ^{[5
]}

Lin, Anthony ^{[5
]}

Fagan, Paul ^{[5
]}

Bathgate, Andrea ^{[5
]}

Patel, Saloni ^{[5
]}

Mak, Josephine ^{[5
]}

Espiner, Emma ^{[6
]}

Poole, Garth ^{[6
]}

Hassan, Summer ^{[6
]}

Javed, Zunaira ^{[6
]}

Randall, Madi ^{[6
]}

机构：

[1] Auckland City Hosp, Auckland, New Zealand

[2] Greenlane Clin Ctr, Auckland, New Zealand

[3] Tauranga Hosp, Tauranga, New Zealand

[4] Christchurch Hosp, Canterbury, New Zealand

[5] Wellington Hosp, Wellington, New Zealand

[6] Manukau Surg Ctr, Auckland, New Zealand

[7] Hastings Hosp, Hastings, New Zealand

[8] Hutt Hosp, Lower Hutt, New Zealand

[9] Rotorua Hosp, Rotorua, New Zealand

[10] Palmerston North Hosp, Palmerston North, New Zealand

[11] Whangarei Base Hosp, Whangarei, New Zealand

[12] Dunedin Publ Hosp, Dunedin, New Zealand

[13] New Plymouth Hosp, New Plymouth, New Zealand

[14] Waikato Hosp, Waikato, New Zealand

[15] Masterton Hosp, Masterton, New Zealand

[16] North Shore Elect Surg Ctr, Takapuna, New Zealand

[17] North Shore Hosp, Auckland, New Zealand

[18] Whanganui Hosp, Whanganui, New Zealand

来源：

HPB | 2023年 / 25卷 / 08期

关键词：

DELAYED LAPAROSCOPIC CHOLECYSTECTOMY; ACUTE GALLSTONE DISEASE; INDEX CHOLECYSTECTOMY; QUALITY IMPROVEMENT; HOSPITAL STAY; SURGERY; CLASSIFICATION; COMPLICATIONS; MANAGEMENT; CHALLENGE;

D O I：

10.1016/j.hpb.2023.04.011

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Introduction: Cholecystectomy for benign biliary disease is common and its delivery should be standardised. However, the current practice of cholecystectomy in Aotearoa New Zealand is unknown.Methods: A prospective, national cohort study of consecutive patients having cholecystectomy for benign biliary disease was performed between August and October 2021 with 30-day follow-up, through STRATA, a student-and trainee-led collaborative.Results: Data were collected for 1171 patients from 16 centres. 651 (55.6%) had an acute operation at index admission, 304 (26.0%) had delayed cholecystectomy following a previous admission, and 216 (18.4%) had an elective operation with no preceding acute admissions. The median adjusted rate of index cholecystectomy (as a proportion of index and delayed cholecystectomy) was 71.9% (range 27.2%-87.3%). The median adjusted rate of elective cholecystectomy (as proportion of all cholecys-tectomies) was 20.8% (range 6.7%-35.4%). Variations across centres were significant (p < 0.001) and inadequately explained by patient, operative, or hospital-factors (index cholecystectomy model R-2 = 25.8, elective cholecystectomy model R-2 = 50.6).Conclusions: Notable variation in the rates of index and elective cholecystectomy exists in Aotearoa New Zealand not attributable to patient, operative or hospital factors alone. National quality improvement efforts to standardise availability of cholecystectomy are needed.

引用

页码：941 / 953

页数：13

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