Protocol driven management of suspected common duct stones: A Southwestern Surgical Congress multi-centered trial.
Am J Surg
; 218(6): 1152-1155, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31558305
ABSTRACT
BACKGROUND:
Several options exist for the diagnosis and management of suspected common duct stones. We hypothesized that a protocol-directed approach would shorten length of stay in this patient population.METHODS:
Patients from four participating institutions with a peak bilirubin <4â¯mg/dL underwent surgery as the initial procedure, whereas patients with a bilirubin ≥4â¯mg/dL underwent endoscopy. The primary endpoint was length of stay. Analysis involved chi square and Wilcoxon-Mann-Whitney test with significance at pâ¯<â¯0.05.RESULTS:
214 patients were managed under the protocol during six-month study period. 111 patients (52%) required endoscopy and surgery. Length of stay and the number of MRCPs performed pre-operatively significantly decreased following protocol implementation (pâ¯<â¯0.05).CONCLUSIONS:
"Surgery first" approach in patients with bilirubin <4â¯ml/dL resulted in low morbidity and mortality, reduced MRCP, and length of stay.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Protocolos Clínicos
/
Colecistectomia Laparoscópica
/
Coledocolitíase
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article