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7 results on '"Al-Akash, M"'

1. Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Author

Griffiths, E. A., Hodson, J., Vohra, R. S., Marriott, P., Katbeh, T., Zino, S., Nassar, A. H. M., Kirkham, A. J., Pasquali, S., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Hornby, R. S. S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Mohamed, S. L. S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Bhandari, C. T. S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Harilingam, A. C. M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Amari, K. A., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., El-Dhuwaib, A. P. Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Angharad Jones, M., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Ross Carter, C., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., John Terrace, S. O. N., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, MEDLINE, cholecystectomy, difficulty grading, laparoscopic, Surgery, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, Humans, Prospective Studies, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Laparoscopic cholecystectomy, Aged, business.industry, General surgery, Correction, Hepatology, Length of Stay, Middle Aged, Conversion to Open Surgery, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, business, Grading scale, Abdominal surgery
Abstract

A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall's tau for dichotomous variables, or Jonckheere-Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p 0.001).We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.

Published
2018

2. The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Author

Bharamgoudar, R., Sonsale, A., Hodson, J., Griffiths, E., Vohra, R.S., Kirkham, A.J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E.A., Fenwick, S., Elmasry, M., Nunes, Q.M., Kennedy, D., Khan, R.B., Khan, M.A.S., Magee, C.J., Jones, S.M., Mason, D., Parappally, C.P., Mathur, P., Saunders, M., Jamel, S., Haque, S.U., Zafar, S., Shiwani, M.H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R.S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P.B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R.L., Weerasinghe, C., Needham, P.J., Welbourn, H., Forster, L., Finch, D., Blazeby, J.M., Robb, W., McNair, A.G.K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.-B., Jayanthi, N.V.G., Noor, N., Dobbins, B., Cockbain, A.J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J.B., Ho, W.-M., Miu, V., White, T.J., Hodgkins, K.A., Kinghorn, A., Tutton, M.G., Al-Abed, Y.A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L.J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S.J., McCallum, I.J.D., Jones, M.J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K.B., Kimble, A., Bunting, D.M., Fawole, A.S., Basheer, M., Dave, R.V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M.P., Gough, M., Wallace, T., Singh, S., Mockford, J.D.K.A., Issa, E., Shah, N., Chauhan, N., Wilson, T.R., Forouzanfar, A., Wild, J.R.L., Nofal, E., Bunnell, C., Madbak, K., Rao, S.T.V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J.C., Gould, L., Chambers, A., Rodriguez, D.U., Sen, G., Robinson, S., Bartlett, F., Rae, D.M., Stevenson, T.E.J., Sarvananthan, K., Dwerryhouse, S.J., Higgs, S.M., Old, O.J., Hardy, T.J., Shah, R., Hornby, S.T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E.A., Frame, R.J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T.O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W.S., Fleming, K., Bajwa, D.S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M.A., Bellini, M.I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N.F., Aggarwal, S.K., Orchard, P., Villatoro, E., Willson, P.D., Mok, K.W.J., Woodman, T., Deguara, J., Garcea, G., Babu, B.I., Dennison, A.R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J.P., Jones, R.P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M.M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S.R., Sampat, K., O?shea, K.M., Manu, M., Asprou, F.M., Malik, N.S., Chang, J., Lewis, M., Roberts, G.P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O?Reilly, D.A., Rate, A.J., Sekhar, H., Henderson, L.T., Starmer, B.Z., Coe, P.O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A.E.J., Borowski, D.W., Hornsby, J., Courtney, M.J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P.V., Reid, A., Wood, P., Finch, J.G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F.M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D.R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S.K.C., Carter, N.C., Tate, S., Pearce, B., Wainwright, D., Mercer, S.J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S.S., Hussain, A.A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M.N., Chishti, I.A., Fordham, I.J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A.K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S.F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M.I., Ball, W.R., Wood, C.P.J., Pinho-Gomes, A.C., Kausar, A., Obeidallah, M.R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S.Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M.R., Goh, Y.L., Turner, P., Shetty, V., Riera, M., Macano, C.A.W., Sukha, A., Preston, S.R., Hoban, J.R., Puntis, D.J., Williams, S.V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G.H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R.T., Sheel, A.R.G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E.R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D.A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C.R., Yeldham, G., Read, E., Gossage, J.A., Rolph, R.C., Ebied, H., Phull, M., Khan, M.A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J.R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N.A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A.R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J.P., Pearson, K.L., Delisle, T.G., Davies, J., Tomlinson, M.A., Johnpulle, M.A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B.S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A.Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P.A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R.C., Hebbar, M., Farag, S.F., Spearman, J., Hamdan, M.F., D?Costa, C., Blane, C., Giles, M., Peter, M.B., Hirst, N.A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T.E.M., Taylor, G.W., Thompson, R.L.E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C.K., Simpson, D.J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W.M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A.D.K., Cassidy, J.T., Boland, M., Burke, P., Nally, D.M., Khogali, E., Shabo, W., Iskandar, E., McEntee, G.P., O?Neill, M.A., Peirce, C., Lyons, E.M., O?Sullivan, A.W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D.C., Kelly, M.E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J.G., McDermott, F., Martin, S.T., Cross, K.S., Cooke, F., Zeeshan, S., Murphy, J.O., Mealy, K., Mohan, H.M., Nedujchelyn, Y., Ullah, M.F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A.M., Vaughan, E.M., Ramage, M.I., Aldridge, R.C., Gibson, S., Nicholson, G.A., Vass, D.G., Grant, A.J., Holroyd, D.J., Jones, M.A., Sutton, C.M.L.R., O?Dwyer, P., Nilsson, F., Weber, B., Williamson, T.K., Lalla, K., Bryant, A., Carter, C.R., Forrest, C.R., Hunter, D.I., Nassar, A.H., Orizu, M.N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A.T., Guthrie, G.J.K., Lim, P.J., Luhmann, A., Watson, A.J.M., Richards, C.H., Nicol, L., Madurska, M., Harrison, E., Boyce, K.M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M.S.J., Dalgaty, F., Fothergill, L., Driscoll, P.J., Mozolowski, K.L., Banwell, V., Bennett, S.P., Rogers, P.N., Skelly, B.L., Rutherford, C.L., Mirza, A.K., Lazim, T., Lim, H.C.C., Duke, D., Ahmed, T., Beasley, W.D., Wilkinson, M.D., Maharaj, G., Malcolm, C., Brown, T.H., Al-Sarireh, B., Shingler, G.M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D.J., Baker, A.L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J.A., Singh-Ranger, D., Hisham, E., Ainley, P., O?Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., McGuigan, A., Shahin, Y., Aymon, Luther, A.A., Nicholson, J.A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, Scoring tool, medicine.medical_specialty, Patient factors, medicine.medical_treatment, Operative Time, Operative duration, 030230 surgery, Logistic regression, Article, patient factors, 03 medical and health sciences, Laparoscopic cholecystectomy, 0302 clinical medicine, Patient satisfaction, 030202 anesthesiology, Interquartile range, medicine, Humans, theatre utilisation, Propensity Score, Aged, Framingham Risk Score, Receiver operating characteristic, business.industry, prediction, Middle Aged, operative duration, Cholecystectomy, Laparoscopic, ROC Curve, scoring tool, Centre for Surgical Research, Elective Surgical Procedures, Theatre utilisation, Emergency medicine, Cohort, Propensity score matching, Female, Surgery, Cholecystectomy, Prediction, business
Abstract

Background The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care.

Published
2018
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3. Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Author

Vohra, RS, Pasquali, S, Kirkham, AJ, Marriott, P, Johnstone, M, Spreadborough, P, Alderson, D, Griffiths, EA, Fenwick, S, Elmasry, M, Nunes, Q, Kennedy, D, Khan, RB, Khan, MAS, Magee, CJ, Jones, SM, Mason, D, Parappally, CP, Mathur, P, Saunders, M, Jamel, S, Ul Haque, S, Zafar, S, Shiwani, MH, Samuel, N, Dar, F, Jackson, A, Lovett, B, Dindyal, S, Winter, H, Fletcher, T, Rahman, S, Wheatley, K, Nieto, T, Ayaani, S, Youssef, H, Nijjar, RS, Watkin, H, Naumann, D, Emeshi, S, Sarmah, PB, Lee, K, Joji, N, Heath, J, Teasdale, RL, Weerasinghe, C, Needham, PJ, Welbourn, H, Forster, L, Finch, D, Blazeby, JM, Robb, W, McNair, AGK, Hrycaiczuk, A, Kadirkamanathan, S, Tang, C-B, Jayanthi, NVG, Noor, N, Dobbins, B, Cockbain, AJ, Nilsen-Nunn, A, de Siqueira, J, Pellen, M, Cowley, JB, Ho, W-M, Miu, V, White, TJ, Hodgkins, KA, Kinghorn, A, Tutton, MG, Al-Abed, YA, Menzies, D, Ahmad, A, Reed, J, Khan, S, Monk, D, Vitone, LJ, Murtaza, G, Joel, A, Brennan, S, Shier, D, Zhang, C, Yoganathan, T, Robinson, SJ, McCallum, IJD, Jones, MJ, Elsayed, M, Tuck, L, Wayman, J, Carney, K, Aroori, S, Hosie, KB, Kimble, A, Bunting, DM, Fawole, AS, Basheer, M, Dave, RV, Sarveswaran, J, Jones, E, Kendal, C, Tilston, MP, Gough, M, Wallace, T, Singh, S, Downing, J, Mockford, KA, Issa, E, Shah, N, Chauhan, N, Wilson, TR, Forouzanfar, A, Wild, JRL, Nofal, E, Bunnell, C, Madbak, K, Rao, STV, Devoto, L, Siddiqi, N, Khawaja, Z, Hewes, JC, Gould, L, Chambers, A, Rodriguez, DU, Sen, G, Robinson, S, Bartlett, F, Rae, DM, Stevenson, TEJ, Sarvananthan, K, Dwerryhouse, SJ, Higgs, SM, Old, OJ, Hardy, TJ, Shah, R, Hornby, ST, Keogh, K, Frank, L, Al-Akash, M, Upchurch, EA, Frame, RJ, Hughes, M, Jelley, C, Weaver, S, Roy, S, Sillo, TO, Galanopoulos, G, Cuming, T, Cunha, P, Tayeh, S, Kaptanis, S, Heshaishi, M, Eisawi, A, Abayomi, M, Ngu, WS, Fleming, K, Bajwa, DS, Chitre, V, Aryal, K, Ferris, P, Silva, M, Lammy, S, Mohamed, S, Khawaja, A, Hussain, A, Ghazanfar, MA, Bellini, MI, Ebdewi, H, Elshaer, M, Gravante, G, Drake, B, Ogedegbe, A, Mukherjee, D, Arhi, C, Iqbal, LGN, Watson, NF, Aggarwal, SK, Orchard, P, Villatoro, E, Willson, PD, Wa, K, Mok, J, Woodman, T, Deguara, J, Garcea, G, Babu, BI, Dennison, AR, Malde, D, Lloyd, D, Satheesan, S, Al-Taan, O, Boddy, A, Slavin, JP, Jones, RP, Ballance, L, Gerakopoulos, S, Jambulingam, P, Mansour, S, Sakai, N, Acharya, V, Sadat, MM, Karim, L, Larkin, D, Amin, K, Khan, A, Law, J, Jamdar, S, Smith, SR, Sampat, K, O'Shea, KM, Manu, M, Asprou, FM, Malik, NS, Chang, J, Lewis, M, Roberts, GP, Karavadra, B, Photi, E, Hewes, J, Rodriguez, D, O'Reilly, DA, Rate, AJ, Sekhar, H, Henderson, LT, Starmer, BZ, Coe, PO, Tolofari, S, Barrie, J, Bashir, G, Sloane, J, Madanipour, S, Halkias, C, Trevatt, AEJ, Borowski, DW, Hornsby, J, Courtney, MJ, Seymour, K, Hawkins, H, Bawa, S, Gallagher, PV, Reid, A, Wood, P, Finch, JG, Parmar, J, Stirland, E, Gardner-Thorpe, J, Al-Muhktar, A, Peterson, M, Majeed, A, Bajwa, FM, Martin, J, Choy, A, Tsang, A, Pore, N, Andrew, DR, Al-Khyatt, W, Taylor, C, Bhandari, S, Subramanium, D, Toh, SKC, Carter, NC, Mercer, SJ, Knight, B, Tate, S, Pearce, B, Wainwright, D, Vijay, V, Alagaratnam, S, Sinha, S, El-Hasani, SS, Hussain, AA, Bhattacharya, V, Kansal, N, Fasih, T, Jackson, C, Siddiqui, MN, Chishti, IA, Fordham, IJ, Siddiqui, Z, Bausbacher, H, Geogloma, I, Gurung, K, Tsavellas, G, Basynat, P, Shrestha, AK, Basu, S, Harilingam, ACM, Rabie, M, Akhtar, M, Kumar, P, Jafferbhoy, SF, Hussain, N, Raza, S, Haque, M, Alam, I, Aseem, R, Patel, S, Asad, M, Booth, MI, Ball, WR, Wood, CPJ, Pinho-Gomes, AC, Kausar, A, Obeidallah, MR, Varghase, J, Lodhia, J, Bradley, D, Rengifo, C, Lindsay, D, Gopalswamy, S, Finlay, I, Wardle, S, Bullen, N, Iftikhar, SY, Awan, A, Ahmed, J, Leeder, P, Fusai, G, Bond-Smith, G, Psica, A, Puri, Y, Hou, D, Noble, F, Szentpali, K, Broadhurst, J, Date, R, Hossack, MR, Goh, YL, Turner, P, Shetty, V, Riera, M, Macano, CAW, Sukha, A, Preston, SR, Hoban, JR, Puntis, DJ, Williams, SV, Krysztopik, R, Kynaston, J, Batt, J, Doe, M, Goscimski, A, Jones, GH, Hall, C, Carty, N, Panteleimonitis, S, Gunasekera, RT, Sheel, ARG, Lennon, H, Hindley, C, Reddy, M, Kenny, R, Elkheir, N, McGlone, ER, Rajaganeshan, R, Hancorn, K, Hargreaves, A, Prasad, R, Longbotham, DA, Vijayanand, D, Wijetunga, I, Ziprin, P, Nicolay, CR, Yeldham, G, Read, E, Gossage, JA, Rolph, RC, Ebied, H, Phull, M, Khan, MA, Popplewell, M, Kyriakidis, D, Henley, N, Packer, JR, Derbyshire, L, Porter, J, Appleton, S, Farouk, M, Basra, M, Jennings, NA, Ali, S, Kanakala, V, Ali, H, Lane, R, Dickson-Lowe, R, Zarsadias, P, Mirza, D, Puig, S, Al Amari, K, Vijayan, D, Sutcliffe, R, Marudanayagam, R, Hamady, Z, Prasad, AR, Patel, A, Durkin, D, Kaur, P, Bowen, L, Byrne, JP, Pearson, KL, Delisle, TG, Davies, J, Tomlinson, MA, Johnpulle, MA, Slawinski, C, Macdonald, A, Nicholson, J, Newton, K, Mbuvi, J, Farooq, A, Mothe, BS, Zafrani, Z, Brett, D, Francombe, J, Barnes, J, Cheung, M, Al-Bahrani, AZ, Preziosi, G, Urbonas, T, Alberts, J, Mallik, M, Patel, K, Segaran, A, Doulias, T, Sufi, PA, Yao, C, Pollock, S, Manzelli, A, Wajed, S, Kourkulos, M, Pezzuto, R, Wadley, M, Hamilton, E, Jaunoo, S, Padwick, R, Sayegh, M, Newton, RC, Hebbar, M, Farag, SF, Spearman, J, Hamdan, MF, D'Costa, C, Blane, C, Giles, M, Peter, MB, Hirst, NA, Hossain, T, Pannu, A, El-Dhuwaib, Y, Morrison, TEM, Taylor, GW, Thompson, RLE, McCune, K, Loughlin, P, Lawther, R, Byrnes, CK, Simpson, DJ, Mawhinney, A, Warren, C, Mckay, D, McIlmunn, C, Martin, S, MacArtney, M, Diamond, T, Davey, P, Jones, C, Clements, JM, Digney, R, Chan, WM, McCain, S, Gull, S, Janeczko, A, Dorrian, E, Harris, A, Dawson, S, Johnston, D, McAree, B, Ghareeb, E, Thomas, G, Connelly, M, McKenzie, S, Cieplucha, K, Spence, G, Campbell, W, Hooks, G, Bradley, N, Hill, ADK, Cassidy, JT, Boland, M, Burke, P, Nally, DM, Khogali, E, Shabo, W, Iskandar, E, McEntee, GP, O'Neill, MA, Peirce, C, Lyons, EM, O'Sullivan, AW, Thakkar, R, Carroll, P, Ivanovski, I, Balfe, P, Lee, M, Winter, DC, Kelly, ME, Hoti, E, Maguire, D, Karunakaran, P, Geoghegan, JG, Martin, ST, McDermott, F, Cross, KS, Cooke, F, Zeeshan, S, Murphy, JO, Mealy, K, Mohan, HM, Nedujchelyn, Y, Ullah, MF, Ahmed, I, Giovinazzo, F, Milburn, J, Prince, S, Brooke, E, Buchan, J, Khalil, AM, Vaughan, EM, Ramage, MI, Aldridge, RC, Gibson, S, Nicholson, GA, Vass, DG, Grant, AJ, Holroyd, DJ, Jones, MA, Sutton, CMLR, O'Dwyer, P, Nilsson, F, Weber, B, Williamson, TK, Lalla, K, Bryant, A, Carter, CR, Forrest, CR, Hunter, DI, Nassar, AH, Orizu, MN, Knight, K, Qandeel, H, Suttie, S, Belding, R, McClarey, A, Boyd, AT, Guthrie, GJK, Lim, PJ, Luhmann, A, Watson, AJM, Richards, CH, Nicol, L, Madurska, M, Harrison, E, Boyce, KM, Roebuck, A, Ferguson, G, Pati, P, Wilson, MSJ, Dalgaty, F, Fothergill, L, Driscoll, PJ, Mozolowski, KL, Banwell, V, Bennett, SP, Rogers, PN, Skelly, BL, Rutherford, CL, Mirza, AK, Lazim, T, Lim, HCC, Duke, D, Ahmed, T, Beasley, WD, Wilkinson, MD, Maharaj, G, Malcolm, C, Brown, TH, Shingler, GM, Mowbray, N, Radwan, R, Morcous, P, Wood, S, Kadhim, A, Stewart, DJ, Baker, AL, Tanner, N, Shenoy, H, Hafiz, S, De Marchi, JA, Singh-Ranger, D, Hisham, E, Ainley, P, O'Neill, S, Terrace, J, Napetti, S, Hopwood, B, Rhys, T, Kanavati, O, Coats, M, Aleksandrov, D, Kallaway, C, Yahya, S, Templeton, A, Trotter, M, Lo, C, Dhillon, A, Heywood, N, Aawsaj, Y, Hamdan, A, Reece-Bolton, O, McGuigan, A, Shahin, Y, Ali, A, Luther, A, Nicholson, JA, Rajendran, I, Boal, M, Ritchie, J, Grp, CS, and Collaborative, WMR

Subjects
Male, medicine.medical_treatment, 030230 surgery, outcomes, 0302 clinical medicine, Postoperative Complications, 80 and over, Prospective Studies, Prospective cohort study, Aged, 80 and over, education.field_of_study, Middle Aged, Conversion to Open Surgery, medicine.anatomical_structure, Treatment Outcome, Cholecystectomy, Laparoscopic, Centre for Surgical Research, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Cohort, Female, Elective Surgical Procedure, Adult, medicine.medical_specialty, Population, Gallbladder disease, Gallbladder Diseases, Aged, Ambulatory Surgical Procedures, Cholecystectomy, Emergency Treatment, Humans, Ireland, Patient Readmission, Time-to-Treatment, United Kingdom, Surgery, benign disease, 03 medical and health sciences, Laparoscopic, medicine, education, business.industry, General surgery, Gallbladder, medicine.disease, business, Complication
Abstract

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.

Published
2016
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4. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Author

Vohra, R. S., Pasquali, S., Kirkham, A. J., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q., Kennedy, D., Basit Khan, R., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Ul Haque, S., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emeshi, S., Sarmah, P. B., Lee, K., Joji, N., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Downing, J., Mockford, K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Urriza Rodriguez, D., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Singh Bajwa, D., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa Nusrat Iqbal, L., Watson, N. F., Kumar Aggarwal, S., Orchard, P., Villatoro, E., Willson, P. D., Wa, K., Mok, J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., M O'shea, K., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S. K. C., Carter, N. C., Mercer, S. J., Knight, B., Tate, S., Pearce, B., Wainwright, D., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Kiran Shrestha, A., Basu, S., Chhabra Mohan Harilingam, A., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Rami Obeidallah, M., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Li Goh, Y., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Sidhartha Mothe, B., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. 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Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Gallbladder disease, Population, Gallbladder Diseases, 030230 surgery, Biliary colic, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Emergency cholecystectomy, benign gallbladder disease, hospital care, 80 and over, Medicine, Humans, Cholecystectomy, Prospective Studies, Prospective cohort study, education, Emergency Treatment, Aged, Aged, 80 and over, education.field_of_study, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, General surgery, Gallbladder, Middle Aged, medicine.disease, Hospitals, United Kingdom, Hospitalization, medicine.anatomical_structure, Centre for Surgical Research, 030220 oncology & carcinogenesis, Female, Ireland, Surgery, medicine.symptom, business, Cohort study
Abstract

Background The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals. Methods Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals. Conclusion Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Published
2016
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5. Experimental detection of antioxidant and atherogenic effects of grapes seeds extracts in rabbits.

Author

Al-Bajari, Sh. A., Al-Akash, M. A., and Ismail, H. Kh.

Subjects
*ANTIOXIDANTS, *GLUTATHIONE, *SEEDS
Abstract

The aim of this study was to determine the ability of Grapes seeds (Vitis vinifera) aqueous, proteinous, non- proteinous and alcoholic extracts as antioxidant and antiatherogenic in rabbits after exposure to 0.5% H2O2 in drinking water for 30 days. The results illustrated capability of 0.5% H2O2 to initiate oxidative stress via significant decrease in Glutathione (GSH), glutathione peroxdiase (GPx), Catalase (CAT) and superoxide dismutase (SOD) level in heart and liver concomitant with significant increase in malondialhyde (MDA) in addition to decrease in high density lipoprotein- cholesterol (HDL-c) and increase low density lipoprotein- cholesterol (LDL-c) in serum of treated only with H2O2 rabbits. While rabbits treated with H2O2 associated with Grapes seeds (aqueous, proteinous, non- proteinous and alcohol) extracts for 15 days showed a significant increase of Glutathione (GSH), glutathione peroxdiase (GPx), superoxide dismutase (SOD) concentration in the heart and liver tissue as well as increase HDL-c, decrease in LDL-c and VLDL-c. While, the histolopathological examination of heart and liver tissue demonstrated that H2O2 induces, degeneration, necrosis and few inflammation foci in the liver and myocardial muscle. While the administration of (Vitis vinifera) aqueous, proteinous, non-proteinous and alcoholic extracts cause improvement in the histological picture of the liver and the myocardial muscle. It was concluded that the (Grapes extracts) aqueous, proteinous, non-proteinous and especially the alcoholic extracts can reduce the damage caused by H2O2 and this will pave the way to investigate the protective effects of the natural substances in the diseases caused by oxidative stress. [ABSTRACT FROM AUTHOR]

Published
2019

6. Abdominal wall herniae and their underlying pathology.

Author

Upchurch E and Al-Akash M

Abstract

We describe a case of pseudomyxoma peritonei presenting as a strangulated inguinal hernia. We review the current literature regarding the incidence of underlying pathology in patients presenting with abdominal wall herniae and discuss the need for histological assessment of the hernia sac in selected patients. We highlight the importance of assessing for and being aware of significant underlying pathology in certain patients., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2016
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7. Small cell cervical cancer: an unusual finding at cholecystectomy.

Author

Boyle E, Nzewi E, Khan I, Al-Akash M, Crotty P, and Neary PC

Subjects
Carcinoma, Small Cell pathology, Cholelithiasis surgery, Female, Gallbladder Neoplasms secondary, Humans, Immunohistochemistry, Laparoscopy, Middle Aged, Postoperative Complications, Renal Insufficiency etiology, Tomography, X-Ray Computed, Ureteral Neoplasms complications, Ureteral Neoplasms secondary, Ureteral Obstruction complications, Uterine Cervical Neoplasms pathology, Carcinoma, Small Cell diagnosis, Cholecystectomy, Uterine Cervical Neoplasms diagnosis
Abstract

Background: Small cell carcinoma of the cervix is a rare cancer, comprising less than 3% of all cervical neoplasms. It uniformly has a poor prognosis, and has a high mortality even with early stage disease. It can metastasise rapidly and metastatic sites include lung, liver, brain, bone, pancreas and lymph nodes., Case: Here, we report the case of a 60-year-old woman with no symptoms of cervical pathology who developed post-renal failure following a laparoscopic cholecystectomy. The cause was bilateral ureteric obstruction from metastatic small cell cervical cancer and metastases were subsequently found on her gallbladder specimen., Conclusion: This is an unusual presentation of small cell cervical cancer and demonstrates the aggressive nature of this disease.

Published
2009
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