Published online Jun 16, 2024. doi: 10.4253/wjge.v16.i6.350
Revised: April 25, 2024
Accepted: May 10, 2024
Published online: June 16, 2024
Processing time: 109 Days and 11.3 Hours
Elective cholecystectomy (CCY) is recommended for patients with gallstone-related acute cholangitis (AC) following endoscopic decompression to prevent recurrent biliary events. However, the optimal timing and implications of CCY remain unclear.
To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database (NRD).
We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020. Our primary outcome was all-cause 30-d readmission rates, and secondary outcomes included in-hospital mortality, length of stay (LOS), and hospitalization cost.
Among the 124964 gallstone-related AC hospitalizations, only 14.67% underwent the same admission CCY. The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group (5.56% vs 11.50%). Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attributable to surgery. Although the most common reason for readmission was sepsis in both groups, the second most common reason was AC in the interval CCY group.
Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission. These readmis
Core Tip: Utilizing the National Readmission Database, we examined the outcomes of index admission cholecystectomy (CCY) vs interval CCY in patients with gallstone-related acute cholangitis (AC). This study revealed that patients undergoing CCY during the same hospital admission for AC exhibited significantly lower 30-d readmission rates than those receiving interval CCY. This approach not only reduces the frequency of subsequent acute hospital visits but also highlights the potential cost benefits by lowering hospitalization expenses. These findings advocate for a reevaluation of current clinical practices concerning the timing of CCY post- endoscopic retrograde cholangiopancreatography, suggesting that earlier interventions could enhance patient outcomes and optimize resource utilization.