Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis. BJS 2017; 104: 1686-1694.
Published: 9th August 2017
Authors: R. Green, S. C. Charman, T. Palser
Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition.
A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined.
During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4–84·7) per cent. In the 1‐year follow‐up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (
In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care.Read more
You may also be interested in
Survival following liver transplantation for liver‐only colorectal metastases compared with hepatocellular carcinoma.
Authors: S. Dueland, A. Foss, J. M. Solheim, M. Hagness, P.‐D. Line
Notes: Valid treatment option for colorectal liver metastases
Propensity score‐matched comparison of oncological outcomes between laparoscopic and open distal pancreatic resection.
Authors: M. Raoof, P. H. G. Ituarte, Y. Woo, S. G. Warner, G. Singh, Y. Fong et al.
Notes: No difference in survival
Authors: M. G. Keane, A. Shamali, L. N. Nilsson, A. Antila, J. Millastre Bocos, M. Marijinissen Van Zanten et al.
Notes: Low risk in small, asymptomatic mucinous cystic neoplasms
Authors: A. ten Hove, V. E. de Meijer, J. B. F. Hulscher, R. H. J. de Kleine
Notes: Choledochal cysts should be resected
Authors: M. Gelli, M. A. Allard, O. Farges, C. Paugam‐Burtz, J. Y. Mabrut, J. M. Regimbeau et al.
Notes: No increased risk
Meta‐analysis of delayed gastric emptying after pylorus‐preserving versus pylorus‐resecting pancreatoduodenectomy. BJS 2018; 105: 339-349.
Authors: U. Klaiber, P. Probst, O. Strobel, C. W. Michalski, C. Dörr‐Harim, M. K. Diener et al.
Notes: No difference
Meta‐analysis of mortality in patients with high‐risk intraductal papillary mucinous neoplasms under observation. BJS 2018; 105: 328-338.
Authors: G. Vanella, S. Crippa, L. Archibugi, P. G. Arcidiacono, G. Delle Fave, M. Falconi et al.
Notes: Low disease‐related mortality
Authors: P. Studer, T. Horn, A. Haynes, D. Candinas, V. M. Banz
Randomized clinical trial
Randomized clinical trial of adjuvant gemcitabine chemotherapy versus observation in resected bile duct cancer. BJS 2018; 105: 192-202.
Authors: T. Ebata, S. Hirano, M. Konishi, K. Uesaka, Y. Tsuchiya, M. Ohtsuka et al.
Notes: No advantage
Defining the molecular pathology of pancreatic body and tail adenocarcinoma. BJS 2018; 105: e183-e191.
Authors: S. B. Dreyer, N. B. Jamieson, R. Upstill‐Goddard, P. J. Bailey, C. J. McKay, A. V. Biankin et al.
Notes: Worse genetic profile in tail
Circulating tumour cells and DNA as liquid biopsies in gastrointestinal cancer. BJS 2018; 105: e110-e120.
Authors: O. Nordgård, K. Tjensvoll, B. Gilje, K. Søreide
Notes: The inner space frontier
Authors: M. A. Stammes, S. L. Bugby, T. Porta, K. Pierzchalski, T. Devling, C. Otto et al.
Notes: Visible results