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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 | Selective and non- selective autophagic degradation of mitochondria in yeast 显示文摘 | Kissova I Salin B Schaeffer J | 2007 | Autophagy2007，3，4： | 1 |
| 3 | Mapping and quantifying mammalian transcriptomes by RNA-Seq显示文摘 | Mortazavi A Williams B A McCue Kh Schaeffer L Wold B | 2008 | Nature Methods2008，5，7： | 1 |
| 4 | Establishment and characterization of bovine mammary myoepithelial cell line 显示文摘 | Zavizion B van Duffelen M Schaeffer W | 1996 | In Vitro Cell Dev Biol-Anim1996，32，： | 1 |
| 5 | High - dose Methyprednisolone is an alternative treatment for adults with autoimmune thrombocytopenic purpura refractory to intravenous immunoglobulins and o ral corticosteroids显示文摘 | Zini JM Schaeffer A | 1995 | Am J Hemato11995，48，： | 1 |
| 6 | Responses of Picea,Pinus and Pseudotsuga roots to heterogeneous nutrient distribution in soil 显示文摘 | GEORGE E SEITH B SCHAEFFER C | 1997 | Tree Physiol1997，17，1： | 1 |
| 7 | 17 Beta-estra- diol-induced antidepressant-like effect in the forced swim test is ab- sent in estrogen receptor-beta knockout (BERKO) mice显示文摘 | ROCHA B A FLEISCHER R SCHAEFFER J M | 2005 | Psycho- pharmacology ( Berl )2005，179，3： | 1 |
| 8 | Fusion of bacterial protoplasts显示文摘 | Schaeffer P B Hothkiss R D | 1976 | Proc Natl Acad Sci USA1976，3，6： | 1 |
| 9 | Assessment of three mitochondrial genes(16 S,Cytb,CO1) for identifying species in the Praomyini tribe (Rodentia: Muridae)显示文摘 | Nicolas V Schaeffer B Missoup A D | 2012 | Plos One2012，7，36： | 1 |
| 10 | Assessment of three mitochondrial genes(16S,Cytb,CO1)for identifying species in the Praomyini tribe(Rodentia:Muridae)显示文摘 | Nicolas V Schaeffer B Missoup AD | 2012 | PLoS One2012，7，36： | 1 |
| 11 | P16 expression in relation to human papillomavirus in liquid-based cervical smears显示文摘 | Samama B Schaeffer C Boehm N | 2008 | Gy- necol Oncol2008，109，2： | 1 |
| 12 | Fusion of bacterial protoplasts 显示文摘 | SCHAEFFER P CAMI B HOTCHKISS R D | 1976 | Proc Natl Acad Sci USA1976，73，6： | 1 |
| 13 | Synergy of entry inhibitors with direct-Acting antivirals uncovers novel combinations for prevention and treatment of hepatitis C显示文摘 | Xiao F Fofana I Thumann C Mailly L Alles R Robinet E Meyer N Schaeffer M Habersetzer F Doffol M Leyssen P Neyts J Zeisel M B Baumert T F | 2014 | Gut2014，，： | 1 |
| 14 | Responses of Picea, Pinus and Pseudotsuga roots to heterogeneous nutrientdistribut ion in soil 显示文摘 | George E Seith B Schaeffer C | 1997 | Tree Physiology1997，17，： | 1 |
| 15 | Expression of insulin-like growth factor 2 in mesenchymal neoplasms 显示文摘 | Steigen S E Schaeffer D F West R B | 2009 | Modem Pathology2009，22，7： | 1 |
| 16 | Ciprofloxacin or tam-sulosin in men with chronic prostatitis/chronic pelvic pain syndrome:a randomized doubleblind trial显示文摘 | Alexander R B Propert K J Schaeffer A J | | 0，，： | 1 |
| 17 | Molecular basis of uropathogenic Escherichia coli evasion of the innate response in the bladder 显示文摘 | Billips B K Schaeffer A J Klumpp D J | 2008 | Infect lmmun2008，76，9： | 1 |
| 18 | Fusion of bacterial protoplasts显示文摘 | Schaeffer P B Hothkiss R D | 1976 | Proc Nat Acad Sci USA1976，3，6： | 1 |
| 19 | Mapping and quantifying mammalian transcriptomes by RNA-Seq显示文摘 | Mortazavi A Williams BA McCue K Schaeffer L Wold B | 2008 | Nat Methods2008，5，7： | 1 |
| 20 | Ciprofloxacin or tam-sulosin in men with chronic prostatitis/chronic pelvic pain syndrome:a randomized,double-blind trial显示文摘 | Alexander R B Propert K J Schaeffer A J | | 0，，08： | 1 |
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