1. Nationwide Outcomes following Percutaneous Cholecystostomy for Acute Calculous Cholecystitis and the Impact of Coronavirus Disease 2019: Results of the Multicentre Audit of Cholecystostomy and Further Interventions (MACAFI study)
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Andrew MacCormick, Paul Jenkins, Jim Zhong, Gregory C. Makris, Nelofer Gafoor, David Chan, John Brittenden, David Stockell, Vinesh Palanimuthu, Yousef Shahin, Naomi Hersey, Thomas Geh, Joe Kang, Maria Sukhanenko, Zheng Dao Yin, Wei Sheng Pang, Dominic McGowan, Lokesh Saraswat, Nabil Ali, Usman Mahay, Katrina Harborne, Rahul Chivate, Romman Nourzaie, Niall Burke, Benedict Thomson, Gregory Makris, Christopher Clarke, Mehreen Yousuff, James Davies, John Sammut, Cherian George, Salman Javed Arain, Damian Mullan, Katherine Sophie Moore, Emile King, Zelei Yang, Chantal Liu, Alicia Skervin, Bankole Oyewole, Ajay Belgaumkar, Georgiana Zamfir, Matthew John Seager, Dinesh Madhavan Ramalingam Sethumadhavan, Praveen Peddu, Hunain Shiwani, Niaz Ahmed, Usman Goga, Mohammed Rashid Akthar, Arjun Bhondi, Fahad Mohammad, Can Hazar, Conor Aleman, Alex Hardman, James Murdoch, Mohamed Kasem, Syed Rahman, Edward Wigmore, Cameron Bullock, Andrew Gemmell, Omotolani Lewis, Joshua Lee, Sabrina Mason, Jun-Li Tham, Choong Leng Poon, Charlotte Jones, Ashley Thorpe, Vinay Kumar Doddaballapur, Tarryn Carlsson, Andrew White, Tonia Forjoe, Gaurav Sundar, A.J. Greenwood, Katherine Lewis, Karen Man Yan Chan, Amr Moussa, Kelvin Tan, Michael Crawford, Tariq Ali, Yasir Sabir, Amjad Chamsi Basha, Wing Yan Liu, Samuel Walker, Tze Hung Siah, Akash Ganguly, Mohammad Haroon Akram, Shian Patel, Drew Maclean, Harriet Williams-Gunn, Matthew O'Brien, Hannah Cliffe, Flavius Parvulescu, Joey Fong, Jins Kallampallil, Symeon Lechareas, Dexter Valencia, Pubudu Piyatissa, Robert Bakewell, Nicholas Heptonstall, Nadeem Shaida, Michael Ryder, Ketan Gaikwad, Vinay Gangadharan, Abubakar Habib, Gautam Menon, Abdishakur Mohamed, Jackson Pat, Nick Railton, Matthew Tam, Yong Keen Hor, Claire Ryan, Timothy Guest, Naeem Jagirdar, Madhurima R. Chetan, Faraaz Khan, Andrew MacDonald, Jim Zhong Kit Yeng Wong, Mahak Shah, Simon Burbidge, and Mayooreshan Anandarajah
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Abstract
To assess the mortality, readmission rates, and practice variation of percutaneous cholecystostomy (PC) in patients with acute calculous cholecystitis in the United Kingdom (UK).A total of 1,186 consecutive patients (636 men [53.6%]; median age, 75 years; range, 24-102 years) who underwent PC for acute calculous cholecystitis between January 1, 2019, and December 31, 2020, were included from 36 UK hospitals. The exclusion criteria were diagnostic aspirations, absence of acute calculous cholecystitis, and age less than 16 years. The coronavirus disease 2019 (COVID-19) lockdown was declared on March 26, 2020, in the UK, which served to distinguish among groups.Most patients (66.3%) underwent PC as definitive treatment, whereas 31.3% underwent PC as a bridge to surgery. The overall 30-day readmission rate was 42.2% (500/1,186), and the 30-day mortality was 9.1% (108/1,186). Centers performing fewer than 30 PCs per year had higher 90-day mortality than those performing more than 60 (19.3% vs 11.0%, respectively; P = .006). A greater proportion of patients presented with complicated acute calculous cholecystitis during the COVID-19 pandemic compared to prior (49.9% vs 40.9%, respectively; P = .007), resulting in more PCs (61.3 vs 37.9 per month, respectively; P.001). More PCs were performed in tertiary hospitals than in district general hospitals (9 vs 3 per 100 beds, respectively; P.001), with a greater proportion performed as a bridge to surgery (50.5% vs 22.8%, respectively; P.001).The practice of PC is highly variable throughout the UK. The readmission rates are high, and there is significant correlation between mortality and PC case volume.
- Published
- 2022