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Impact of an Acute Care Surgery Model with a Dedicated Daytime Operating Room on Outcomes and Timeliness of Care in Patients with Biliary Tract Disease

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Although many acute care surgery (ACS) formats exist, the model established in 2006 at our academic, level 1 trauma center includes a dedicated daytime operating room. The goal of the present study was to evaluate the effect that an ACS model with a dedicated daytime operating suite would have on outcomes and timeliness of care in patients with biliary tract disease.


A retrospective cohort study was performed on all patients with biliary tract disease admitted to the University of Alberta Hospital pre- and post-ACS. Data collected included demographic information, medical diagnoses, procedures performed, and complications. Time points included the time from admission to operation, operative time, and length of hospital stay. Pre- and post-ACS groups were compared with the Pearson Chi square test and Student’s t test (α = 0.05).


There were 72 patients pre-ACS and 172 post-ACS. The two groups had similar demographics and co-morbidities. The post-ACS group had a shorter time from admission to operation (34.1 vs 24.8 h; p < 0.05). There was a decrease in the number of patients awaiting daytime operating room availability (95.8 vs 60.7 %; p < 0.05), with most surgeries being done within a 24 h period versus patients waiting upwards of 3 days pre-ACS.


We observed a significant decrease in preoperative time by 10 h with increased access to a readily available operating room. Having a dedicated ACS team is important, but it is equally important to have a dedicated operating room with disposable time to care for unpredictable, emergent cases to realize the full potential benefit of the ACS model.

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  1. Hameed SM, Widder S et al (2010) General surgery 2.0: the emergence of acute care surgery in Canada. Can J Surg 53:79–82

    PubMed  Google Scholar 

  2. Ball CG, Maclean AR, Dixon E et al (2012) Acute care surgery: the impact of an acute care surgery service on assessment, flow, and disposition in the emergency department. Am J Surg 203:578–583

    Article  PubMed  Google Scholar 

  3. Miller PR, Wildman EA, Chang MC et al (2012) Acute care surgery: impact on practice and economics of elective surgeons. J Am Coll Surg 214:531–535

    Article  PubMed  Google Scholar 

  4. David KA, Rozycki GS (2010) Acute care surgery in evolution. Crit Care Med 38:S405–S410

    Article  Google Scholar 

  5. Britt RC, Weireter LJ, Britt LD (2009) Initial implementation of an acute care surgery model: implications for timeliness of care. J Am Coll Surg 209:421–424

    Article  PubMed  Google Scholar 

  6. Ball C, Hameed SM, Brenneman FD (2010) Acute care surgery: a new strategy for the general surgery patients left behind. Can J Surg 53:84–85

    PubMed  Google Scholar 

  7. Ekeh AP, Monson B, Wozniak C et al (2008) Management of acute appendicitis by an acute care surgery service: is operative intervention timely? J Am Coll Surg 207:43–48

    Article  PubMed  Google Scholar 

  8. Earley AS, Pryor JP, Kim PK et al (2006) An acute care surgery model improves outcomes in patients with appendicitis. Ann Surg 244:498–504

    PubMed  Google Scholar 

  9. Britt RC, Bouchard C, Weireter J et al (2010) Impact of acute care surgery on biliary disease. J Am Coll Sug 210:595–601

    Article  Google Scholar 

  10. Lehane CW, Jootun RN, Bennett M et al (2010) Does an acute care surgical model improve the management and outcome of acute cholecystitis? ANZ J Surg 80:438–442

    Article  PubMed  Google Scholar 

  11. Lau B, DiFronzo A (2011) An acute care surgery model improves timeliness of care and reduces hospital stay for patients with acute cholecystitis. Am Surg 77:1318–1321

    PubMed  Google Scholar 

  12. Casillas RA, Yegiyants S, Collins JC (2008) Early laparoscopic cholecystectomy is the preferred management of acute cholecystitis. Arch Surg 143:533–537

    Article  PubMed  Google Scholar 

  13. Shikata S, Noguchi Y, Fukui T (2005) Early versus delayed cholecystectomy for acute cholecystitis: a meta-analysis of randomized controlled trials. Surg Today 35:553–560

    Article  PubMed  Google Scholar 

  14. Wilson E, Gurusamy K, Gluud C et al (2010) Cost-utility and value-of-information analysis of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 97:210–219

    Article  PubMed  CAS  Google Scholar 

  15. Catani M, De Milito R, Romagnoli F et al (2008) The best timing of surgery in laparoscopic cholecystectomy for acute cholecystitis: when and how is it to be performed? Hepatogastroenterology 55:1993–1996

    PubMed  Google Scholar 

  16. Hadad SM, Vaidya JS, Baker L et al (2007) Delay from symptom onset increases the conversion rate in laparoscopic cholecystectomy for acute cholecystitis. World J Surg 31:1298–1301. doi:10.1007/s00268-007-9050-2

    Article  PubMed  Google Scholar 

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Correspondence to Sandy Widder.

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Lim, D.W., Ozegovic, D., Khadaroo, R.G. et al. Impact of an Acute Care Surgery Model with a Dedicated Daytime Operating Room on Outcomes and Timeliness of Care in Patients with Biliary Tract Disease. World J Surg 37, 2266–2272 (2013).

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