Early cholecystectomy after acute admission with cholecystitis: how much work?
BACKGROUND
This study was designed to determine the number of cases and amount of operating room time required, for a population of 600,000, to provide definitive treatment in the form of cholecystectomy for all patients admitted as an emergency with cholecystitis.


METHODS
The total number of patients admitted to a single NHS trust in South East Wales with the diagnosis of cholecystitis during a 1-year period was assessed. The number of laparoscopic cholecystectomies performed and the time taken was investigated with the conversion rates.


RESULTS
There were a total of 787 individual emergency admissions attributed to cholecystitis, and 224 patients (36%) underwent cholecystectomy on the same admission. The median operative time was 77 (range, 23-238) min, and the median operating room time was 108 (range, 37-278) min. To treat all patients definitively would necessitate 12 cholecystectomies per week, requiring 1,296 min or 5.4 sessions of operating room time.


CONCLUSIONS
A population of 600,000 could be expected to generate enough emergency cholecystectomies to require more than one operating session per day. A significant increase in emergency operating room availability would be necessary to allow the provision of definitive treatment for all emergency admissions with cholelithiasis.
Stephens
Michael R
MR
Department of Surgery, Nevill Hall Hospital, Gwent Healthcare NHS Trust, Brecon Road, Abergavenny, UK. mikestephens@doctors.org.uk
Beaton
Ceri
C
Steger
Adrian C
AC
D002763:Cholecystectomy / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D002764:Cholecystitis / Q000601:surgery*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration*; D013222:State Medicine; D013997:Time Factors; D014852:Wales; D016526:Workload