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 Wolf, Paul A. Nakonezny, Herb A. 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
Externally publishedYes

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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 Steven Wolf and Nakonezny, {Paul A.} and Phelan, {Herb A.}",
year = "2015",
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doi = "10.1016/j.amjsurg.2015.07.009",
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T1 - Establishing benchmarks for the management of elevated liver enzymes and/or dilated biliary trees in an urban safety net hospital

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

AU - Nakonezny, Paul A.

AU - Phelan, Herb A.

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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