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The impact of interval cholecystectomy timing after percutaneous transhepatic cholecystostomy on post-operative adverse outcomes

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Abstract

Objective

This study aims to explore how timing of interval of cholecystectomy (IC) after percutaneous transhepatic cholecystostomy tube (PTC) placement impacts post-operative outcomes.

Methods

A retrospective database analysis of New York State SPARCs database of IC between 2005 and 2015. The timing for IC ranged between > 1 week and < 2 years. Patients undergoing this procedure were further divided into quartiles using 4-time intervals; 1–5 weeks (Q1), 5–8 weeks (Q2), 8–12 weeks(Q3), and > 12 weeks(Q4). The study’s primary outcome was hospital length of stay (LOS). Secondary outcomes included discharge status, 30-day readmission, 30-day ED visit, and 90-day reoperation, surgery type, complication, and bile duct injury. Multivariable regression models were used to compare patients across the four-time intervals after adjusting for confounding factors.

Results

A total of 1038 patients with a history of PTC followed by IC between > 1 week and < 2 years were included in the final analysis. The median time to IC was 7.7 weeks. Q2 and Q3 both had a significantly higher median LOS of 3 days versus Q1 and Q4 at median of 5 days (p < 0.0001). Patients from racial and ethnic minorities (e.g., African Americans and Hispanics) were more likely to get their IC after 12 weeks (p < 0.05). Further, Black patients had a significantly higher median LOS than White, non-Hispanic patients (8 days vs 4 days, p < 0.0001) and were more likely to have open procedure. Multivariable regression analysis identified shorter LOS during Q2 (Ratio, 0.76, 95%, 0.67–0.87, p < 0.0001), and Q3 (Ratio 0.75, 95% CI, 065–0.86, p < 0.0001) compared to those who got their IC in Q4. Similar findings exist when comparing Q2 and Q3 to those receiving treatment during Q1.

Conclusion

A time interval of 5–12 weeks between PTC and IC was associated with a decreased LOS. This study also suggests the persistence of racial disparities among these patients.

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Funding

This work was funded by the Department of Surgery at Stony Brook.

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Authors and Affiliations

  1. Department of Surgery, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, 27517, USA

    Mohammad Noubani

  2. Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, USA

    Ila Sethi & Konstantinos Spaniolas

  3. Department of Surgery, Christiana Care, Wilmington, DE, USA

    Elizabeth McCarthy

  4. Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, USA

    Samuel L. Stanley

  5. Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA

    Xiaoyue Zhang & Jie Yang

  6. Department of Surgery, Northwell Health System, Manhasset, NY, USA

    Aurora D. Pryor

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  1. Mohammad Noubani
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Corresponding author

Correspondence to Mohammad Noubani.

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Disclosures

This work was funded by the department of surgery at Stony Brook University Hospital. Aurora D. Pryor: Speaker for Ethicon, Gore, Medtronic and Stryker and a consultant for Ethicon. Konstantinos Spaniolas: Speaker for Gore. Mohammad Noubani, Ila Sethi, Elizabeth McCarthy, Samuel L. Stanley, Xiaoyue Zhang, Jie Yang have no other conflicts of interest are declared by the authors.

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Noubani, M., Sethi, I., McCarthy, E. et al. The impact of interval cholecystectomy timing after percutaneous transhepatic cholecystostomy on post-operative adverse outcomes. Surg Endosc 37, 9132–9138 (2023). https://doi.org/10.1007/s00464-023-10451-w

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  • DOI: https://doi.org/10.1007/s00464-023-10451-w

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