• Am. J. Surg. · Dec 2014

    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 O'Keeffe, Andrew L Tang, Gary Vercruysse, and Peter Rhee.
    • Division of Acute Care Surgery, Department of Surgery, University of Arizona, Room 5411, 1501 North Campbell Avenue, PO Box 245603, Tucson, AZ 85727-5063, USA. Electronic address: nkulvatunyou@surgery.arizona.edu.
    • Am. J. Surg. 2014 Dec 1; 208 (6): 981-7; discussion 986-7.

    BackgroundWe 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.MethodsWe 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.ResultsFifty 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.ConclusionsAdmitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.Copyright © 2014 Elsevier Inc. All rights reserved.

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