Protocol driven management of suspected common duct stones: A Southwestern Surgical Congress multi-centered trial - 21/11/19
Abstract |
Background |
Several options exist for the diagnosis and management of suspected common duct stones. We hypothesized that a protocol-directed approach would shorten length of stay in this patient population.
Methods |
Patients from four participating institutions with a peak bilirubin <4 mg/dL underwent surgery as the initial procedure, whereas patients with a bilirubin ≥4 mg/dL underwent endoscopy. The primary endpoint was length of stay. Analysis involved chi square and Wilcoxon-Mann-Whitney test with significance at p < 0.05.
Results |
214 patients were managed under the protocol during six-month study period. 111 patients (52%) required endoscopy and surgery. Length of stay and the number of MRCPs performed pre-operatively significantly decreased following protocol implementation (p < 0.05).
Conclusions |
“Surgery first” approach in patients with bilirubin <4 ml/dL resulted in low morbidity and mortality, reduced MRCP, and length of stay.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Protocol utilizing bilirubin <4 mg/dL for surgery first approach was adopted. |
• | Retrospective multicenter review of 214 patients with suspected common duct stones was performed. |
• | Comparison to the results of prior multicenter review prior to protocol adoption. |
• | Significant decrease in length of stay with protocol implementation. |
Keywords : Cholecystectomy, Choledocholithiasis, Common bile duct stones
Plan
Vol 218 - N° 6
P. 1152-1155 - décembre 2019 Retour au numéro
Article précédent
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