A retrospective study of laparoscopic, robotic-assisted, and open emergent/urgent cholecystectomy based on the PINC AI Healthcare Database 2017–2020.

Background: Robotic-assisted cholecystectomy (RAC) is becoming increasingly common, but the outcomes of emergent/urgent robotic-assisted cholecystectomies compared to emergent laparoscopic (LC) and open cholecystectomies (OC) remain understudied. Methods: The PINC AI Healthcare Database was queried...

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Publicado en:World Journal of Emergency Surgery Vol. 18; no. 1; pp. 1 - 13
Autores principales: Campbell, Stephen, Lee, Shih-Hao, Liu, Yuki, Wren, Sherry M.
Formato: research tables/charts Journal Article
Publicado: BioMed Central 11/30/2023
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: World Journal of Emergency Surgery
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      dt: 11/30/2023
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      pub: BioMed Central
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        10.1186/s13017-023-00521-8
        173925932
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        atl: A retrospective study of laparoscopic, robotic-assisted, and open emergent/urgent cholecystectomy based on the PINC AI Healthcare Database 2017–2020.
      aug:
        au:
          Campbell, Stephen
          Lee, Shih-Hao
          Liu, Yuki
          Wren, Sherry M.
        affil: VA Medical Center, Palo Alto Division, 3801 Miranda Avenue, 94304, Palo Alto, CA, USA
      sug:
        subj:
          Cholecystectomy, Laparoscopic
          Robotic Surgical Procedures Methods
          Emergency Medical Services
          Treatment Outcomes
          Human
          Intraoperative Complications
          Blood Transfusion
          Postoperative Complications
          Length of Stay
          Probability
          Bile Ducts Injuries
          Obesity
          Comparative Studies
          Retrospective Design
          Funding Source
      ab: Background: Robotic-assisted cholecystectomy (RAC) is becoming increasingly common, but the outcomes of emergent/urgent robotic-assisted cholecystectomies compared to emergent laparoscopic (LC) and open cholecystectomies (OC) remain understudied. Methods: The PINC AI Healthcare Database was queried to identify adults who underwent emergent or urgent (Em-Ur) cholecystectomy between January 1, 2017, and December 31, 2020. Immediate postoperative and 30-day outcomes were identified including intraoperative complications, transfusion, conversion, postoperative complication, and hospital length of stay. Propensity score matching was done to compare outcomes between Em-Ur robotic-assisted, laparoscopic, and open cholecystectomies Subgroup analyses were performed comparing RAC done with and without fluorescent imaging as well as comparing RAC and LC performed for patients with class 3 obesity (BMI ≥ 40 kg/m2). Results: RAC Em-Ur cholecystectomies are being performed with increasing frequency and is the most utilized modality for patients with class 3 obesity. There was no difference in intraoperative complications (0.3%), bile duct injury (0.2%), or postoperative outcomes between RAC and LC. LC had significantly shorter operating room times (96 min (75,128)) compared to RAC (120 min (90,150)). There was a significant lower rate of conversion to open in RAC (1.9%) relative to LC (3.2%) in both the overall population and the class 3 obesity sub-analysis (RAC-2.6% vs. LC-4.4%). There was no difference in outcomes in robotic-assisted cholecystectomies done with and without fluorescent imaging. Conclusions: A comparison of propensity score-matched cohorts of emergent/urgent robotic-assisted and laparoscopic cholecystectomy indicates that robotic-assisted cholecystectomy is a safe alternative to laparoscopic cholecystectomy, and that both have superior outcomes to open cholecystectomies.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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