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Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis with mild pancreatitis

Current Medical Science 2020年第5期40卷 937-942页

作者： Lu WANG Hai-feng YU Tong GUO Peng XIE Zhi-wei ZHANG Ya-hong YU Department of Biliopancreatic Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Critical Medicine Yueyang First People's HospitalYueyang 414000China

The safety and feasibility of early laparoscopic cholecystectomy(LC)for acute cholecystitis with mild pancreatitis were explored.A total of 973 patients with acute pancreatitis,including 651 mild cases and 322 moderate or severe cases were retrospectively studied from July 2014 to December 2018 in our *** 426 mild pancreatitis cases with acute cholecystitis were enrolled in this study,of which 328 patients underwent LC during the same-admission(early LC group),and 98 patients underwent LC a period of time after conservative treatment(delayed LC group).Clinical characteristics,operative findings and complications were recorded and followed *** two groups were comparable in age,gender,the grade of American Society of Anesthesiologist(ASA),biochemical findings and Balthazar computer tomography(CT)rating(P>0.05).The operation interval and hospital stay in early LC group were significantly shorter than in delayed LC group(5.83+1.62 vs.41.3618.44 days;11.38+2.43 vs.16.49+3.48 days,Pmild pancreatitis.

关键词： acute cholecystiti mild pancreatitis laparoscopic cholecystectomy

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Innovative pathways allow safe discharge of mild acute pancreatitis from the emergency room

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World Journal of Gastroenterology 2024年第11期30卷 1475-1479页

作者： Darshan J Kothari Sunil G Sheth Division of Gastroenterology Duke University Medical CenterDurhamNC 27710United States Division of Gastroenterology&Hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States

Acute pancreatitis(AP)is a leading cause of gastrointestinal-related hospitalizations in the United States,resulting in 300000 admissions per year with an estimated cost of over$2.6 billion *** severity of AP is determined by the presence of pancreatic complications and end-organ *** moderate/severe pancreatitis can be associated with significant morbidity and mortality,the majority of patients have a mild presentation with an uncomplicated course and mortality rate of less than 2%.Despite favorable outcomes,the majority of mild AP patients are admitted,contributing to healthcare cost and *** this Editorial we review the performance of an emergency department(ED)pathway for patients with mild AP at a tertiary care center with the goal of reducing hospitalizations,resource utilization,and costs after several years of implementation of the *** discuss the clinical course and outcomes of mild AP patients enrolled in the pathway who were successfully discharged from the ED compared to those who were admitted to the hospital,and identify predictors of successful ED discharge to select patients who can potentially be triaged to the *** conclude that by implementing innovative clinical pathways which are established and reproducible,selected AP patients can be safely discharged from the ED,reducing hospitalizations and healthcare costs,without compromising clinical *** also identify a subset of patients most likely to succeed in this pathway.

关键词： Emergency department mild pancreatitis Pathways Hospitalization Predictors

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