National recurrence of pancreatitis and readmissions after biliary pancreatitis

Background National and international guidelines support early cholecystectomy after mild gallstone pancreatitis but a recent nationwide study suggested these recommendations are not universally followed. Our study sought to quantify the national utilization of same hospitalization cholecystectomy v...

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Bibliographic Details
Published in:Surgical endoscopy 2022-10, Vol.36 (10), p.7399-7408
Main Authors: Rios-Diaz, Arturo J., Lamm, Ryan, Metcalfe, David, Devin, Courtney L., Pucci, Michael J., Palazzo, Francesco
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Cholecystectomy
Female
Gallstones
Gallstones - complications
Gallstones - surgery
Gastroenterology
Generalized linear models
Gynecology
Health services utilization
Hepatology
Hospital costs
Hospitalization
Humans
Length of Stay
Medicine
Medicine & Public Health
Mortality
Pancreatitis
Pancreatitis - complications
Pancreatitis - therapy
Patient Readmission
Proctology
Recurrence
Retrospective Studies
Surgery
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Summary:Background National and international guidelines support early cholecystectomy after mild gallstone pancreatitis but a recent nationwide study suggested these recommendations are not universally followed. Our study sought to quantify the national utilization of same hospitalization cholecystectomy versus non-operative management (NOM) and its association with pancreatitis recurrence, readmissions, and costs after mild gallstone pancreatitis (GP). Methods Adult patients admitted with mild GP were identified from the Nationwide Readmission Database 2010–2015. Primary outcomes included the rate of cholecystectomy during the index admission as well as pancreatitis recurrence and readmission at 30 and 180 days (30d, 180d) comparing NOM to same hospitalization cholecystectomy. Mortality upon readmission, total length of stay (LOS), and total costs (combined index-readmission hospital costs) were also explored. Cox proportional hazards regression and generalized linear models controlled for patient/hospital confounders. Results Among the 65,067 patients identified, 30% underwent cholecystectomy. The NOM cohort was older (58 vs. 50 years), had more comorbidities (Charlson index > 2, 23.5% vs. 11.5%), fewer female patients (56.7% vs. 67%) and less discharge-to-home (84.9% vs. 94.4%) (all p  
ISSN:0930-2794
1432-2218
DOI:10.1007/s00464-022-09153-6