Financial Burden Secondary to Delay in Cholecystectomy Following Mild Biliary Pancreatitis. (4th May 2017)

• Record Type: Journal Article
• Authors: Boshnaq, Mohamed H.; Merali, Nabeel; El Abbassy, Islam H.; Eldesouky, Sayed A.; Rabie, Mohamed A.
• Is Part Of: Journal of investigative surgery. Volume 30:Number 3(2017)
• Page Start: 170
• Page End: 176
• Publication Date: 2017-05-04
• Subjects: pancreatitis -- gallstones -- cholecystectomy -- biliary colic; Surgery -- Research -- Periodicals; Research; Surgery; Surgical Procedures, Operative; 617.075
• DOI: 10.1080/08941939.2016.1231857
• Languages: English
• ISSNs: 0894-1939

Abstract

ABSTRACT: Aim of the study : The guidelines recommend that patients with mild gallstones pancreatitis should undergo a definitive management for gallstones during the same admission or within the next two weeks. The aim of this study was to estimate the financial cost resulting from a delay in surgical management following mild gallstones pancreatitis. This includes the costs of readmissions with biliary events and the subsequent investigations required during these admissions. Materials and methods : A retrospective analysis included patients with gallstone pancreatitis who were admitted to a district general hospital in the United Kingdom over one year. Patients with severe pancreatitis and those unfit for surgery were excluded. Results : Forty patients were included in the study, 27 females (67%) and 13 males (33%). Mean age was 50.2 years. Twenty-two patients of the total presented with a single admission with gallstone pancreatitis prior to an elective surgery; however, 18 patients (45%) required recurrent admissions. The duration between the first admission and surgery ranged from 14 to 389 days (median of 99 days). Only one patient (2.5%) had cholecystectomy within two weeks of admission as per guidelines. Twenty-two ultrasound scans, four computed tomography scans, 15 magnetic resonance cholangiopancreatography, and two endoscopic retrograde cholangiopancreatography were the total of the extra-investigations required during readmissions. Estimated costs of extra admissions and extra investigations exceeded £33, 000. Conclusions : The delay in cholecystectomy for patients admitted with mild gallstone pancreatitis and fit for surgery has resulted in high readmission rate with biliary events, and subsequently high extrax costs.