No coin nor oath required. For personal study only.
Aims: Delay in cholecystectomy after admission with symptomatic gallstone disease leaves potential for further morbidity in the interim period. In a district general hospital setting we analysed this time period and the intervening symptoms and morbidity. Methods: A study of patients with an admitting diagnosis related to the sequelae of cholelithiasis was conducted over a 2-years period between 2001 and 2003. Data were collected prospectively. Results: A total of 279 patients were admitted with cholelithiasis (210 with biliary colic, 34 with cholecystitis, 7 with cholangitis and 28 with pancreatitis) of whom 248 had a cholecystectomy at a mean of 237 (range, 8-803) days. There was a significant difference in waiting time for those patients originally admitted with pancreatitis secondary to cholelithiasis and for other sequelae (134 versus 249 days). Fifty-seven (23%) of the patients had unplanned admission(s) while waiting for a cholecystectomy of which 23 (40%) were readmitted within 4 weeks. Conclusions: Delays in cholecystectomy following admission for complications of gallstone disease even of a period of 4 weeks is linked with high readmission rates and with associated morbidity and cost implication.
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