Establishing benchmarks for the management of elevated liver enzymes and/or dilated biliary trees in an urban safety net hospital: Analysis of 915 subjects Presented as an Oral Presentation at the Annual Meeting of the Southwestern Surgical Congress, April 2015, Monterey, CA.

Laindy Liu, Michael W Cripps, Andrew J. Riggle, Steven E Wolf, Paul A Nakonezny, Herbert Phelan

Research output: Contribution to journalArticle

Abstract

Background The push for public reporting of outcomes necessitates relevant benchmarks for disease states across different settings. This study establishes benchmarks for choledocholithiasis management in a safety net hospital setting. Methods We reviewed all patients admitted to our acute care surgery service with biochemical evidence of choledocholithiasis who underwent same-admission cholecystectomy (CCY) between July 2012 and December 2013. Results During this 18-month period, 915 patients were admitted with biochemical evidence of choledocholithiasis. Descriptive statistics for the cohort are provided, which include a 51% rate of obesity and 95% rate of pathologic cholecystitis. Conversion rates of 4% and complication rates of 6% were found. The majority had a CCY without biliary imaging (n = 630, 68.9%). Conclusions Relevant benchmarks are characterized, and results of a practice pattern of omitting pre- or intraoperative biliary tree imaging are described. These findings serve as a first benchmark of choledocholithiasis management for urban safety net hospitals.

Original languageEnglish (US)
Pages (from-to)1132-1139
Number of pages8
JournalAmerican Journal of Surgery
Volume210
Issue number6
DOIs
StatePublished - Dec 1 2015

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Safety-net Providers
Choledocholithiasis
Benchmarking
Biliary Tract
Liver
Cholecystectomy
Enzymes
Cholecystitis
Obesity

Keywords

  • Benchmarking
  • Choledocholithiasis
  • Laparoscopic cholecystectomy
  • Outcome reporting
  • Safety net hospital

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Establishing benchmarks for the management of elevated liver enzymes and/or dilated biliary trees in an urban safety net hospital: Analysis of 915 subjects Presented as an Oral Presentation at the Annual Meeting of the Southwestern Surgical Congress, April 2015, Monterey, CA.",
abstract = "Background The push for public reporting of outcomes necessitates relevant benchmarks for disease states across different settings. This study establishes benchmarks for choledocholithiasis management in a safety net hospital setting. Methods We reviewed all patients admitted to our acute care surgery service with biochemical evidence of choledocholithiasis who underwent same-admission cholecystectomy (CCY) between July 2012 and December 2013. Results During this 18-month period, 915 patients were admitted with biochemical evidence of choledocholithiasis. Descriptive statistics for the cohort are provided, which include a 51{\%} rate of obesity and 95{\%} rate of pathologic cholecystitis. Conversion rates of 4{\%} and complication rates of 6{\%} were found. The majority had a CCY without biliary imaging (n = 630, 68.9{\%}). Conclusions Relevant benchmarks are characterized, and results of a practice pattern of omitting pre- or intraoperative biliary tree imaging are described. These findings serve as a first benchmark of choledocholithiasis management for urban safety net hospitals.",
keywords = "Benchmarking, Choledocholithiasis, Laparoscopic cholecystectomy, Outcome reporting, Safety net hospital",
author = "Laindy Liu and Cripps, {Michael W} and Riggle, {Andrew J.} and Wolf, {Steven E} and Nakonezny, {Paul A} and Herbert Phelan",
year = "2015",
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doi = "10.1016/j.amjsurg.2015.07.009",
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T2 - Analysis of 915 subjects Presented as an Oral Presentation at the Annual Meeting of the Southwestern Surgical Congress, April 2015, Monterey, CA.

AU - Liu, Laindy

AU - Cripps, Michael W

AU - Riggle, Andrew J.

AU - Wolf, Steven E

AU - Nakonezny, Paul A

AU - Phelan, Herbert

PY - 2015/12/1

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N2 - Background The push for public reporting of outcomes necessitates relevant benchmarks for disease states across different settings. This study establishes benchmarks for choledocholithiasis management in a safety net hospital setting. Methods We reviewed all patients admitted to our acute care surgery service with biochemical evidence of choledocholithiasis who underwent same-admission cholecystectomy (CCY) between July 2012 and December 2013. Results During this 18-month period, 915 patients were admitted with biochemical evidence of choledocholithiasis. Descriptive statistics for the cohort are provided, which include a 51% rate of obesity and 95% rate of pathologic cholecystitis. Conversion rates of 4% and complication rates of 6% were found. The majority had a CCY without biliary imaging (n = 630, 68.9%). Conclusions Relevant benchmarks are characterized, and results of a practice pattern of omitting pre- or intraoperative biliary tree imaging are described. These findings serve as a first benchmark of choledocholithiasis management for urban safety net hospitals.

AB - Background The push for public reporting of outcomes necessitates relevant benchmarks for disease states across different settings. This study establishes benchmarks for choledocholithiasis management in a safety net hospital setting. Methods We reviewed all patients admitted to our acute care surgery service with biochemical evidence of choledocholithiasis who underwent same-admission cholecystectomy (CCY) between July 2012 and December 2013. Results During this 18-month period, 915 patients were admitted with biochemical evidence of choledocholithiasis. Descriptive statistics for the cohort are provided, which include a 51% rate of obesity and 95% rate of pathologic cholecystitis. Conversion rates of 4% and complication rates of 6% were found. The majority had a CCY without biliary imaging (n = 630, 68.9%). Conclusions Relevant benchmarks are characterized, and results of a practice pattern of omitting pre- or intraoperative biliary tree imaging are described. These findings serve as a first benchmark of choledocholithiasis management for urban safety net hospitals.

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