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Tang J, Yang J, Yang JS, Lai JX, Ye PC, Hua X, Lv QJ, Wei SJ. Stoma-site approach single-port laparoscopic versus conventional multi-port laparoscopic Miles's procedure for low rectal cancer: A prospective, randomized controlled trial. Asian J Surg 2023; 46:4317-4322. [PMID: 37422394 DOI: 10.1016/j.asjsur.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/01/2023] [Accepted: 06/07/2023] [Indexed: 07/10/2023] Open
Abstract
OBJECTIVE The aim of this study was to compare perioperative outcomes of patients with low rectal cancer after stoma-site approach single-port laparoscopic Miles procedure or conventional multi-port laparoscopic Miles procedure, as well as to evaluate the safety and efficacy of stoma-site approach single-port laparoscopic surgery in low rectal cancer. METHODS Between September 2020 and September 2021, 51 low rectal cancer patients scheduled for Miles procedure at the Department of Gastrointestinal Surgery of Affiliated Hospital of North Sichuan Medical College were randomly assigned to the single-port laparoscopic surgery group (SPLS) and the multi-port laparoscopic surgery (MPLS) group. The perioperative outcomes were compared between the two groups. RESULTS In this study, 25 patients underwent SPLS and 26 underwent MPLS. All patients completed the study, and there were no perioperative deaths in either group. Observation indicators such as intraoperative bleeding (39 mL vs. 41 mL), number of lymph nodes (20.12 ± 3.29 vs. 21.84 ± 3.74), average hospital stay (7.15 ± 1.52 vs. 7.64 ± 1.66), and time to flatulence (2.5d vs. 2.5d) showed no significant differences between the SPLS and MPLS groups (p > 0.05). However, the operation duration (180 min vs. 118 min) and perioperative complications showed statistically significant differences between the two groups (p < 0.05). In addition, patients in the SPLS group had significantly higher satisfaction scores than those in the MPLS group (p < 0.05). CONCLUSION For patients with low rectal cancer requiring Miles surgery, stoma-site approach single-port laparoscopic surgery has comparable safety and efficacy to multi-port laparoscopic surgery.
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Affiliation(s)
- Jin Tang
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China
| | - Jing Yang
- Department of Rheumatology and Immunology, Nanchong Central Hospital, Nanchong, Sichuan, 637000, China
| | - Jun-Song Yang
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China
| | - Jian-Xiong Lai
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China
| | - Peng-Cheng Ye
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China
| | - Xia Hua
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China
| | - Qi-Jun Lv
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China.
| | - Shou-Jiang Wei
- Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China.
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Cillara N, Podda M, Cicalò E, Sotgiu G, Provenzano M, Fransvea P, Poillucci G, Sechi R. A Prospective Cohort Analysis of the Prevalence and Predictive Factors of Delayed Discharge After Laparoscopic Cholecystectomy in Italy: The DeDiLaCo Study. Surg Laparosc Endosc Percutan Tech 2023; 33:463-473. [PMID: 37526464 PMCID: PMC10545073 DOI: 10.1097/sle.0000000000001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/19/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND The concept of early discharge ≤24 hours after Laparoscopic Cholecystectomy (LC) is still doubted in Italy. This prospective multicentre study aims to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge >24 hours in an extensive Italian national database and identify potential limiting factors of early discharge after LC. METHODS This is a prospective observational multicentre study performed from January 1, 2021 to December 31, 2021 by 90 Italian surgical units. RESULTS A total of 4664 patients were included in the study. Clinical reasons were found only for 850 patients (37.7%) discharged >24 hours after LC. After excluding patients with nonclinical reasons for delayed discharge >24 hours, 2 groups based on the length of hospitalization were created: the Early group (≤24 h; 2414 patients, 73.9%) and the Delayed group (>24 h; 850 patients, 26.1%). At the multivariate analysis, ASA III class ( P <0.0001), Charlson's Comorbidity Index (P=0.001), history of choledocholithiasis (P=0.03), presence of peritoneal adhesions (P<0.0001), operative time >60 min (P<0.0001), drain placement (P<0.0001), pain ( P =0.001), postoperative vomiting (P=0.001) and complications (P<0.0001) were independent predictors of delayed discharge >24 hours. CONCLUSIONS The majority of delayed discharges >24 hours after LC in our study were unrelated to the surgery itself. ASA class >II, advanced comorbidity, the presence of peritoneal adhesions, prolonged operative time, and placement of abdominal drainage were intraoperative variables independently associated with failure of early discharge.
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Affiliation(s)
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Italy
| | - Enrico Cicalò
- Department of Architecture, Design and Urban Planning, University of Sassari, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | | | - Pietro Fransvea
- Emergency Surgery and Trauma, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
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Porras Fimbres DC, Nussbaum DP, Mosca PJ. Racial disparities in time to laparoscopic cholecystectomy for acute cholecystitis. Am J Surg 2023; 226:261-270. [PMID: 37149406 DOI: 10.1016/j.amjsurg.2023.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/25/2023] [Accepted: 05/02/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Disparities in healthcare exist, yet few data are available on racial differences in time from admission to surgery. This study aimed to compare time from admission to laparoscopic cholecystectomy for acute cholecystitis between non-Hispanic Black and non-Hispanic White patients. METHODS Patients who underwent laparoscopic cholecystectomy for acute cholecystitis from 2010 to 2020 were identified using NSQIP. Time to surgery and additional preoperative, operative, and postoperative variables were analyzed. RESULTS In the univariate analysis, 19.4% of Black patients experienced a time to surgery >1 day compared with 13.4% of White patients (p < 0.0001). In the multivariable analysis, controlling for potential confounding factors, Black patients were found to be more likely than White patients to experience a time to surgery >1 day (OR 1.23, 95% CI 1.17-1.30, p < 0.0001). CONCLUSIONS Further investigation is indicated to better define the nature and significance of gender, race, and other biases in surgical care. Surgeons should be aware that biases may adversely impact patient care and should strive to identify and proactively address them to promote health equity in surgery.
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Affiliation(s)
| | - Daniel P Nussbaum
- Duke University School of Medicine, Duke University Health System, Durham, NC, USA; Department of Surgery, Duke University School of Medicine, Duke University Health System, Durham, NC, USA; Duke Network Services, Duke University Health System, Durham, NC, USA
| | - Paul J Mosca
- Duke University School of Medicine, Duke University Health System, Durham, NC, USA; Department of Surgery, Duke University School of Medicine, Duke University Health System, Durham, NC, USA; Duke Network Services, Duke University Health System, Durham, NC, USA.
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Joshi Y, Ramakrishnan P, Jindal P, Sachan PK. Ultrasound-guided erector spinae plane block versus port site infiltration for postoperative pain and quality of recovery in adult patients undergoing laparoscopic cholecystectomy: An assessor-blinded randomised controlled trial. Indian J Anaesth 2023; 67:714-719. [PMID: 37693026 PMCID: PMC10488569 DOI: 10.4103/ija.ija_556_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 09/12/2023] Open
Abstract
Background and Aim Pain following laparoscopic cholecystectomy (LC) is common and results in poor quality of recovery. Our study aimed to compare the analgesic efficacy of port site local infiltration, novel erector spinae plane (ESP) block, and standard regimen in patients undergoing LC and its impact on functional recovery. Methods After ethical approval and registering the trial, we randomly allocated 105 adult patients undergoing LC to three groups: Group I (n = 35), received multimodal analgesia; Group II (n = 35), received pre-incisional port site infiltration with 20 ml of 0.375% bupivacaine; and Group III (n = 35), preoperative bilateral ESP block with 20 ml of 0.375% bupivacaine bilaterally was administered. Pain severity, fentanyl consumption, and time to first rescue analgesia were recorded over 24 h. Quality of recovery (QoR-15) was assessed at baseline and 24 h postoperatively. Results Pain in the first 6 h was lowest in the ESP group (P < 0.001). Although static pain in the infiltration group was comparable with that in the ESP group after 6 h (P > 0.05), dynamic pain was better in the ESP group till 20 h postoperatively (P < 0.05). Fentanyl consumption was significantly lower in the ESP group (P < 0.001). Global and sub-dimensional QoR-15 scores were significantly higher only in the ESP group at 24 h compared to the other two groups (P < 0.001). The infiltration group did better than the control group in terms of total opioid requirement (P < 0.001) and Visual Analogue Scale (VAS) score after 6 h (P < 0.001). Conclusion ESP block provided lower postoperative pain scores with opioid-sparing and better quality of recovery in patients undergoing LC.
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Affiliation(s)
- Yashita Joshi
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand, India
| | - Priya Ramakrishnan
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand, India
| | - Parul Jindal
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand, India
| | - Praveendra K. Sachan
- Department of General Surgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun, Uttarakhand, India
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Singh A, Panse NS, Prasath V, Arjani S, Chokshi RJ. Cost-effectiveness analysis of robotic cholecystectomy in the treatment of benign gallbladder disease. Surgery 2023; 173:1323-1328. [PMID: 36914510 DOI: 10.1016/j.surg.2023.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Laparoscopic cholecystectomy is the current standard of care treatment for benign gallbladder disease. Robotic cholecystectomy is another approach for performing cholecystectomy that offers a surgeon better dexterity and visualization. However, robotic cholecystectomy may increase cost without sufficient evidence to suggest an improvement in clinical outcomes. The purpose of this study was to construct a decision tree model to compare cost-effectiveness of laparoscopic cholecystectomy and robotic cholecystectomy. METHODS Complication rates and effectiveness associated with robotic cholecystectomy and laparoscopic cholecystectomy over a 1-year time frame were compared using a decision tree model populated with data from the published literature. Cost was calculated using Medicare data. Effectiveness was represented by quality-adjusted life-years. The primary outcome of the study was incremental cost-effectiveness ratio, which compares the cost per quality-adjusted life-year of the 2 interventions. The willingness-to-pay threshold was set at $100,000/quality-adjusted life-year. Results were confirmed with 1-way, 2-way, and probabilistic sensitivity analyses varying branch-point probabilities. RESULTS The studies used in our analysis included 3,498 patients who underwent laparoscopic cholecystectomy, 1,833 patients who underwent robotic cholecystectomy, and 392 patients who required conversion to open cholecystectomy. Laparoscopic cholecystectomy produced 0.9722 quality-adjusted life-years, costing $9,370.06. Robotic cholecystectomy produced an additional 0.0017 quality-adjusted life-years at an additional $3,013.64. These results equate to an incremental cost-effectiveness ratio of $1,795,735.21/quality-adjusted life-year. This exceeds the willingness-to-pay threshold, making laparoscopic cholecystectomy the more cost-effective strategy. Sensitivity analyses did not alter results. CONCLUSION Traditional laparoscopic cholecystectomy is the more cost-effective treatment modality for benign gallbladder disease. At present, robotic cholecystectomy is not able to improve clinical outcomes enough to justify its added cost.
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Affiliation(s)
- Adityabikram Singh
- Division of Surgical Oncology, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ. https://twitter.com/ad_singh09
| | - Neal S Panse
- Division of Surgical Oncology, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ. https://twitter.com/NealPanse
| | - Vishnu Prasath
- Rutgers New Jersey Medical School, Newark, NJ. https://twitter.com/Vishnu__Prasath
| | - Simran Arjani
- Rutgers New Jersey Medical School, Newark, NJ. https://twitter.com/SimranArjani
| | - Ravi J Chokshi
- Division of Surgical Oncology, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
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Ambulatory anesthesia and discharge: an update around guidelines and trends. Curr Opin Anaesthesiol 2022; 35:691-697. [PMID: 36194149 DOI: 10.1097/aco.0000000000001194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Provide an oversight of recent changes in same-day discharge (SDD) of patient following surgery/anesthesia. RECENT FINDINGS Enhanced recovery after surgery pathways in combination with less invasive surgical techniques have dramatically changed perioperative care. Preparing and optimizing patients preoperatively, minimizing surgical trauma, using fast-acting anesthetics as well as multimodal opioid-sparing analgesia regime and liberal prophylaxis against postoperative nausea and vomiting are basic cornerstones. The scope being to maintain physiology and minimize the impact on homeostasis and subsequently hasten and improve recovery. SUMMARY The increasing adoption of enhanced protocols, including the entire perioperative care bundle, in combination with increased use of minimally invasive surgical techniques have shortened hospital stay. More intermediate procedures are today transferred to ambulatory pathways; SDD or overnight stay only. The traditional scores for assessing discharge eligibility are however still valid. Stable vital signs, awake and oriented, able to ambulate with acceptable pain, and postoperative nausea and vomiting are always needed. Drinking and voiding must be acknowledged but mandatory. Escort and someone at home the first night following surgery are strongly recommended. Explicit information around postoperative care and how to contact healthcare in case of need, as well as a follow-up call day after surgery, are likewise of importance. Mobile apps and remote monitoring are techniques increasingly used to improve postoperative follow-up.
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Zhao H, Zhang Z, Wang Y, Qian B, Cao X, Yang M, Liu Y, Zhao Q. Why does patients’ discharge delay after vertebral augmentation? A factor analysis of 1,442 patients. Front Surg 2022; 9:987500. [PMID: 36211299 PMCID: PMC9538961 DOI: 10.3389/fsurg.2022.987500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Vertebral augmentation techniques are widely used to treat osteoporotic vertebral compression fractures (OVCFs). Superior analgesic effects and shortened bed rest time means patients recover quickly, but prolonged unscheduled hospitalization can increase medical expenses and the risk of bed rest complications. The aim of this study was to investigate the reasons for prolonged hospitalization after vertebral augmentation surgery and to determine the relative risk factors. Methods A single-center retrospective study was conducted to enroll patients with OVCFs and accepted vertebral augmentation surgery from January 2017 to December 2017. Clinical information was collected from the Hospital Information System (HIS). The criterion of delayed discharge was postoperative hospitalization more than 3 days. Telephone interviews and medical history evaluations were conducted to confirm the exact reason for retention. The risk factors were analyzed by multiple logistic regression. Results Overall, 1,442 patients were included, and 191 (13.2%) stayed in the hospital for more than 3 days postoperatively. The reasons for delayed discharge were psychological factors (37.2%), residual pain (32.5%), cardiopulmonary complications (15.7%), nonspecific symptoms (8.4%), incision abnormalities (2.6%), thrombosis (2.1%), and postanesthesia reactions (1.6%). The multiple logistic model was significant; age (OR 1.028; 95% CI 1.009–1.046), preoperative stay (OR 1.192; 95% CI 1.095–1.298), operation type (OR 1.494; 95% CI 1.019–2.189), and the number of surgical segments (OR 2.238; 95% CI 1.512–3.312) showed statistical significance. In contrast, gender (P > 0.1) and chronic comorbidities (P > 0.1) were not predictors in this model. Conclusion Overall, 13.2% of OVCF patients who underwent vertebral augmentation surgery were not discharged within 3 days postoperatively, and several predictors were found. Preoperative communication and comprehensive evaluations are calling for more attention; physicians should adopt an appropriate medical process to enhance rehabilitation in geriatric orthopedics.
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Affiliation(s)
- He Zhao
- Department of Emergency Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Zhengping Zhang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yanjun Wang
- Department of Emergency Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Bing Qian
- Department of Emergency Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Xinhao Cao
- Department of Emergency Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Ming Yang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yangjin Liu
- Department of Emergency Medicine, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Qinpeng Zhao
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- Correspondence: Qinpeng Zhao
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Bai JG, Wang Y, Zhang Y, Lv Y. Expert consensus on the application of the magnetic anchoring and traction technique in thoracoscopic and laparoscopic surgery. Hepatobiliary Pancreat Dis Int 2022; 21:7-9. [PMID: 34289952 DOI: 10.1016/j.hbpd.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 06/28/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Ji-Gang Bai
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yue Wang
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yong Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
| | - Yi Lv
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
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Cao J, Liu B, Shi J, Meng X, Zhang H, Pan Y, Lu S. Safety of ambulatory laparoscopic cholecystectomy in the elderly. ANZ J Surg 2021; 91:597-602. [PMID: 33605041 DOI: 10.1111/ans.16656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/17/2021] [Accepted: 02/02/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aims to retrospectively analyse the safety of ambulatory laparoscopic cholecystectomy (ALC) and identify risk factors for delayed discharge after ALC in the elderly. METHODS Consecutive patients who were scheduled to undergo ALC were assigned to the elderly group (age ≥ 65 years) or the non-elderly group. The primary outcome was postoperative discharge within 24 h (D24). Secondary outcomes were perioperative mortality, reasons for delayed discharge (psychosocial reasons (DP), complications (DC), drainage (DD) and conversion to open surgery (DCO)), intraoperative data and readmission within 30 days after discharge (readmission). Differences were statistically significant when P < 0.05. RESULTS There were 7657 patients assigned to the elderly group (n = 1143) or the non-elderly group (n = 6514). The differences between elderly patients and non-elderly patients in the operation time (51.0 (37.0-70.0) versus 50.0 (35.0-65.0) min), blood loss (10.0 (5.0-10.0) versus 5.0 (5.0-10.0) mL), D24 (75.5% versus 81.7%) and DD (7.8% versus 3.2%) were statistically significant (P < 0.05, respectively). The differences between elderly patients and non-elderly patients in DP (8.2% versus 6.7%), DC (7.8% versus 7.9%), DCO (0.7% versus 0.5%) and readmission (0.5% versus 0.4%) were not statistically significant (P > 0.05, respectively). Independent risk factors for delayed discharge after ALC in the elderly were male sex, octogenarian status, prolonged operation time, arrhythmia, type 2 diabetes mellitus, a previous operation in the upper abdomen, acute inflammation of gallbladder and a gallbladder wall thicker than 3 mm (P < 0.05, respectively). CONCLUSION ALC in the elderly is feasible and safe.
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Affiliation(s)
- Junning Cao
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
| | - Bo Liu
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
| | - Jihang Shi
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xuan Meng
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hangyu Zhang
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yingwei Pan
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
| | - Shichun Lu
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China
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