Management of acute mild gallstone pancreatitis under acute care surgery: Should patients be admitted to the surgery or medicine service?

Narong Kulvatunyou, John Watt, Randall S. Friese, Lynn Gries, Donald J. Green, Bellal Joseph, Terence OKeeffe, Andrew L. Tang, Gary Vercruysse, Peter Rhee

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.

Methods We performed chart reviews of patients who underwent a cholecystectomy for acute mild GSP from October 1, 2009 to May 31, 2013. We excluded patients with moderate to severe and non-gallstone pancreatitis. We compared outcomes for time to surgery, HLOS, costs, and complications between the 2 groups.

Results Fifty acute mild GSP patients were admitted to MED and 52 to SUR. MED patients were older and had more comorbidity. SUR patients had a shorter time to surgery (44 vs 80 hours; P <.001), a shorter HLOS (3 vs 5 days; P <.001), and lower hospital costs ($11,492 ± 6,480 vs $16,183 ± 12,145; P =.03). In our subgroup analysis on patients with an American Society of Anesthesiologists score between 1 and 2, the subgroups were well matched; all outcomes still favored SUR patients.

Conclusions Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.

Original languageEnglish (US)
Pages (from-to)981-987
Number of pages7
JournalAmerican Journal of Surgery
Volume208
Issue number6
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

Keywords

  • Gallstone pancreatitis
  • Medicine service
  • Surgery service

ASJC Scopus subject areas

  • Surgery

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