Evidence map›Paper›PMID 38037953›Full record

Observational studyAnnals of the Royal College of Surgeons of England2024

Paradigm shift towards emergency cholecystectomy: one site experience of the Chole-QuiC process.

M Hamid, J Bird, J Yeo, A Shrestha, M Carter, K Kudhail, A Akingboye, C Sellahewa

Abstract readObservational Study
In one paragraph

Observational study in Annals of the Royal College of Surgeons of England, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

M HamidDudley Group NHS Foundation Trust, UK.
J BirdDudley Group NHS Foundation Trust, UK.
J YeoDudley Group NHS Foundation Trust, UK.
A ShresthaDudley Group NHS Foundation Trust, UK.
M CarterDudley Group NHS Foundation Trust, UK.
K KudhailDudley Group NHS Foundation Trust, UK.
A AkingboyeDudley Group NHS Foundation Trust, UK.
C SellahewaDudley Group NHS Foundation Trust, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSubstantial evidence exists for the superiority of emergency over delayed cholecystectomy for gallstone disease during primary admission. Despite this, emergency surgery rates in the UK remain low compared with other developed countries, with great variation in care across the nation. We aimed to describe the local paradigm shift towards emergency surgery and investigate outcomes.

methodsThis is a prospective observational study examining patients enrolled onto an emergency cholecystectomy pathway, following the hospital's subscription to the Royal College of Surgeons of England's Cholecystectomy Quality Improvement Collaborative (Chole-QuIC), between 1 December 2021 and 31 January 2023. Multivariate logistical regression models were used to identify patient and hospital factors associated with postoperative outcomes.

resultsOf the 307 suitable acute admissions, 261 (85%) had an emergency cholecystectomy, compared with 5% preceding the Chole-QuIC interventions. Waiting time dropped from 67 to 5 days. A total of 208 (79.7%) patients were primary presentations, 92 (35.2%) were classed Tokyo grade 2 and 142 (54.4%) were obese. A total of 23 (8.8%) patients underwent preoperative endoscopic retrograde cholangiopancreatography, and 26 (10%) patients had a subtotal cholecystectomy. Favourable outcomes (Clavien Dindo ≥3) were observed in first presentations (odds ratio (OR) 0.35;

conclusionA paradigm shift towards emergency cholecystectomy benefits both the patient and the service. Positive outcomes are apparent for early operation in patients presenting for the first time and recurrent attendees, with early operation (<7 days) providing the most favourable outcome in a select patient group.

Indexed as

CholecystectomyTime-to-TreatmentAdultAgedAged, 80 and overCholangiopancreatography, Endoscopic RetrogradeEmergenciesEmergency TreatmentEnglandFemaleGallstonesHumansMaleMiddle AgedPostoperative ComplicationsProspective StudiesAcute cholecystitisComplicationsEmergency cholecystectomyPatient outcomesReadmissionSubtotal cholecystectomy

Identifiers

PMID38037953
PMCPMC11365725

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.