EMERGENCY LAPAROSCOPIC CHOLECYSTECTOMY: IS DEDICATED HOT GALL BLADDER LIST COST EFFECTIVE?

Authors

  • Saad Ullah Khan Dudley Group NHS Foundation Trust, West Midlands, United Kingdom.
  • Jun Yi Soh University Hospitals of Birmingham, NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, West Midlands, B15 2TH
  • Nazli Muhibullah Nottingham City Hospital, Hucknall Rd, Nottingham NG5 1PB, UK
  • Aikaterini Peleki Russell’s Hall Hospital, Pensnett Rd, Dudley DY1 2HQ, UK
  • Muhammad Abdullah Dudley Group NHS Foundation Trust, West Midlands,
  • Peter William Waterland Dudley Group NHS Foundation Trust, West Midlands, United Kingdom.

Abstract

Background: Acute presentation of gall stone disease is a common emergency. Resource limitation often results in unnecessary long waiting times and repeat hospital admissions. The aim of this study was to investigate if funding a dedicated hot gall bladder list is justified. Methods: Patients with acute gall stone related complications between 1st January 2016 and 31st December 2017 were studied. Outcome measures included the number of acute admissions, length of hospital stay (LOS), approximate cost per patient. The length of stay was identified as a critical outcome measure. Results: Fourteen hundred and ninety-five (11%) out of 14189 acute surgical admissions were related to gall stone complications. These included acute cholecystitis 576 (39%), biliary colic 485 (32%), pancreatitis 405 (27%) and jaundice 34 (2%). Twelve hundred and twenty-two patients accounted for 1461 admissions. 182 (15%) patients had recurrent admissions (35%) and on average stayed 11.2 days in the hospital compared to 5.8 days for that of single presentation. The cost of emergency LC (£2053) was less than half of elective LC following single emergency admission (£5661) and less than one third of Elective LC following recurrent admissions (£7453). A trust can save £1,891,784 per year by achieving 80% target. The savings can be used to fund a dedicated hot gall bladder list, releasing hospital beds and additional benefit of reducing the workforce days lost to sickness in general. Conclusion: Emergency LC is cost effective and savings made for such a service is sufficient to fund a dedicated hot gall bladder list.Keywords: Laparoscopic; Cholecystectomy; Laparoscopic cholecystectomy; Cost-Benefit Analysis; Hospital Costs; Cost Savings; Costs and Cost Analysis

Author Biographies

Saad Ullah Khan, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom.

Consultant, General and Upper GI Surgeon, Dudley Group NHS Foundation Trust, Pensnett Road, DY1 2HQ, UK (Corresponding author)

Jun Yi Soh, University Hospitals of Birmingham, NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, West Midlands, B15 2TH

Core Trainee, General Surgery

Nazli Muhibullah, Nottingham City Hospital, Hucknall Rd, Nottingham NG5 1PB, UK

Specialist Registrar, General surgery

Aikaterini Peleki, Russell’s Hall Hospital, Pensnett Rd, Dudley DY1 2HQ, UK

Specialist Registrar, General surgery

Muhammad Abdullah, Dudley Group NHS Foundation Trust, West Midlands,

Consultant General & Breast Surgeon, Dudley Group NHS Foundation Trust, Pensnett Road, DY1 2HQ, Dudley UK.

Peter William Waterland, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom.

Consultant, General and Colorectal Surgeon, Dudley Group NHS Foundation Trust, Pensnett Road, DY1 2HQ, UK

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Published

2019-01-06

Issue

Vol. 31 No. 1 (2019): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

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ORIGINAL ARTICLE

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