Document Detail


Outcomes following cholecystectomy in pregnant and nonpregnant women.
MedLine Citation:
PMID:  19628096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study is the first population-based measurement of outcomes after cholecystectomy during pregnancy. METHODS: We identified all pregnant women who underwent cholecystectomy in the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, 1996-2006. Outcomes were fetal, maternal, and surgical complications, length of stay (LOS), and hospital cost. Pregnant and nonpregnant women were compared to examine the effects of pregnancy on laparoscopic cholecystectomy outcomes. RESULTS: A total of 9,714 pregnant women underwent cholecystectomy (laparoscopic, 89%). Maternal and fetal complication rates were 4.3% and 5.8%, respectively. Pregnant women who underwent laparoscopic cholecystectomy compared to pregnant women who underwent open procedures had higher rates of surgical (19% vs 10%), maternal (9% vs 4%), and fetal (11% vs 5%) complications; longer LOS (6 vs 4 days); and higher cost ($13,198 vs $9,229), all P < .0001. High-volume surgeons were associated with lower rates of surgical (10% vs 13%; P < .05), maternal (1% vs 14%), and fetal (4% vs 10%) complications; shorter LOS (4 vs 5 days); and lower cost ($8,365 vs $10,350), all P < .0001. Patients with Medicaid coverage were associated with higher rates of surgical complications (13% vs 9%), longer LOS (4.3 vs 3.7 days), and higher cost ($10,403 vs $9,037), all P < .0001. On multivariable analysis, these factors remained independent predictors of outcome. Pregnancy was associated with longer LOS and higher cost. CONCLUSION: Complications of cholecystectomy during pregnancy are significant, with disparities based on modifiable variables.
Authors:
Sreyram Kuy; Sanziana A Roman; Rani Desai; Julie Ann Sosa
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Surgery     Volume:  146     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  358-66     Citation Subset:  AIM; IM    
Affiliation:
Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT 06520, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biliary Tract Diseases / economics,  surgery
Cholecystectomy* / adverse effects,  economics
Cholecystectomy, Laparoscopic / adverse effects,  economics
Female
Humans
Length of Stay
Middle Aged
Pregnancy
Pregnancy Complications / economics,  surgery*
Socioeconomic Factors
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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