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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 | Efficacy of an esfenvalerate plus methoprene aerosol for the control of eggs and fifth instars of Plodia interpunctella (Lepidoptera: Pyralidae)显示文摘 | Emily A. Jenson Frank H. Arthur James R. Nechols | 2010 | Insect Science2010，17，1： | 3 |
| 3 | Extraction Topographic Structure from Digital Elevation Data for Geographic Information System Analysis显示文摘 | Jenson K Domingue JO | 1998 | Photogrammetry Engineering and Remote Sensing1998，54，11： | 2 |
| 4 | Classification of trochanteric fractures 显示文摘 | Jenson JS | 1980 | Acta Orthop Scand1980，51，： | 1 |
| 5 | Autogenous deformatim and change of the relalive humidity in silica fume-modified cement paste显示文摘 | JENSON 0 M HANSEN P F | 1996 | ACI Materials Journal1996，93，6： | 1 |
| 6 | The Performance of Mutual Funds in the Period 1945-1964显示文摘 | Jenson M | 1968 | Journal of Finance1968，23，2： | 1 |
| 7 | Subpixel edge localization and the interpola- tion of still images 显示文摘 | Jenson K Anastassiou D | 1995 | IEEE Transactions on Image Processing1995，4，3： | 1 |
| 8 | The Modern Industrial Revolution, Exit, and the Failure of Internal Control Systems 显示文摘 | Jenson M | 1993 | The Journal of Finance1993，48，3： | 1 |
| 9 | Extracting topographic structure from digital elevation data for geographic information system analysis显示文摘 | JENSON S K DOMINGUE J O | 1988 | Photogrammetric Engineering and Remote Sensing1988，54，11： | 1 |
| 10 | Temperature Dependence of TIP3P, SPC, and TIP4P Water from NPT Monte Carlo Simulations: Seeking Temperatures of Maximum Density 显示文摘 | Jorgensen W L Jenson C | 1998 | J Comput Chem1998，19，： | 1 |
| 11 | Evidence-based strategies for preventing drug administration errors during anaesthesia显示文摘 | Jenson LS Merry AF Webster CS | 2004 | Anaesthesia2004，59，： | 1 |
| 12 | The separation of ownership and control显示文摘 | Fama E F Jenson M C | 1983 | Journal of Law and Economics1983，26，2： | 1 |
| 13 | Report of the Snus Consen sus Conference of 1996显示文摘 | Jenson OT Shulman LB Block MS | 1998 | Int Oral Maxillofac Implants1998，，： | 1 |
| 14 | Immunol Acute phase proteins in salmonida:evolutionary analyses and acute phase response显示文摘 | Jenson LE Hiney NIP | 1997 | J Immunol1997，158，： | 1 |
| 15 | Relationships of trabecular bone structure with quantitative ultrasound parameters: in vitro study on human proximal femur using transmission and backscatter measurements显示文摘 | Padilla F Jenson F Bousson V | 2008 | Bone2008，42，6： | 1 |
| 16 | Development of zero-phosphorus engine oils显示文摘 | ARUPT K GANGOPADEHYAY R K JENSON R O | 2008 | Lubrication Science2008，20，： | 1 |
| 17 | Extraction Topographic Structure from Digital Elevation Data for Geographic Information System Analysis显示文摘 | JENSON S K DOMINGUE J O | 1988 | Photogrammetirc Engineering and Remote Sensing1988，54，11： | 1 |
| 18 | Immunization of cotton rats with the fusion(F) and large(G) glycoproteins of respiratory syncytial virus (RSV) protects against RSV challenge without potentiating RSV disease显示文摘 | Murphy BR Sotnikov A Paradiso PR Hildreth SW Jenson AB Baggs RB etal | 1989 | Vaccine1989，7，： | 1 |
| 19 | Spin-polarized transport in a two-dimensional electron gas with interdigitalferromagnetic contacts显示文摘 | HU C M NITTA J JENSON A | 2001 | Phys Rev B2001，63，12： | 1 |
| 20 | Molecular and virologic characteristics of lymphoid malignancies in children with AIDS显示文摘 | McClure K L Leach C T Jenson H B | 2000 | J Acquir Immune Defic Syndr2000，23，： | 1 |
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