Acute Care Surgery Model for Emergency Cholecystectomy

다국어 초록 (Multilingual Abstract)

Purpose: Acute care surgery (ACS) models have evolved worldwide over the last decade. However, South Korea has an established trauma system and does not consider the ACS model. This study compares the management and outcome of emergency cholecystectomy in the ACS model to those of traditional on-call attending surgeon model for emergency surgery.Methods: Retrospectively collected data for patients who underwent emergency cholecystec-tomy from May 2013 to January 2015 was analyzed to compare data from a traditional on-call system (OCS) and ACS.Results: One hundred and twenty-four patients were enrolled in the study (62 patients ACS vs. 62 patients OCS). Hospital stay (days) (ACS=4.29±2.49 vs. OCS=4.82±4.48, p=0.46) and stay in emergency room (minutes) (ACS=213.10±113.99 vs. OCS=241.10±150.73, p=0.20) did not differ significantly between groups. Operation time (minutes) was significantly shorter in the ACS than OCS group (389.97±215.21 vs. 566.35±290.14, p＜0.001). Other clinical variables (sex, open-conversion rate, whether the operation was performed at night/holiday, intensive care unit admission rate) did not differ between groups. There was no mortality and readmission.Conclusion: The implementation of the ACS led to shorter operation time and no increase of postoperative mortality and complication. (J Acute Care Surg 2016;6:57-61)

참고문헌 (Reference)

1 Michailidou M, "Time and cost analysis of gallbladder surgery under the acute care surgery model" 76 : 710-714, 2014

2 Qureshi A, "The impact of an acute care emergency surgical service on timely surgical decision-making and emergency department overcrowding" 213 : 284-293, 2011

3 Velmahos GC, "The concept of acute care surgery:a vision for the not-so-distant future" 141 : 288-290, 2007

4 Cubas RF, "Outcomes in the management of appendicitis and cholecystitis in the setting of a new acute care surgery service model: impact on timing and cost" 215 : 715-721, 2012

5 Lim DW, "Impact of an acute care surgery model with a dedicated daytime operating room on outcomes and timeliness of care in patients with biliary tract disease" 37 : 2266-2272, 2013

6 Britt RC, "Impact of acute care surgery on biliary disease" 210 : 595-599, 2010

7 Siddiqui T, "Early versus delayed laparoscopic cholecystectomy for acute cholecystitis:a meta-analysis of randomized clinical trials" 195 : 40-47, 2008

8 Casillas RA, "Early laparoscopic cholecystectomy is the preferred management of acute cholecystitis" 143 : 533-537, 2008

9 Lehane CW, "Does an acute care surgical model improve the management and outcome of acute cholecystitis?" 80 : 438-442, 2010

10 Lau B, "An acute care surgery model improves timeliness of care and reduces hospital stay for patients with acute cholecystitis" 77 : 1318-1321, 2011

11 Coleman JJ, "Acute care surgery: now that we have built it, will they come?" 74 : 463-468, 2013

12 Ball CG, "Acute care surgery: a new strategy for the general surgery patients left behind" 53 : 84-85, 2010