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Your search keyword '"Popplewell, M"' showing total 7 results
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7 results on '"Popplewell, M"'

1. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system

Author

Nassar, A. H. M., Hodson, J., H. J., Ng, Vohra, R. S., Katbeh, T., Zino, S., Griffiths, E. A., Kirkham, A. J., Pasquali, S., Marriott, P., 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., 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, operative difficulty, medicine.medical_specialty, medicine.medical_treatment, Difficulty grading, difficult cholecystectomy, predictive score, surgery, laparoscopic, cholecystectomy, Surgical planning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Preoperative Care, Humans, Medicine, Laparoscopic cholecystectomy, Framingham Risk Score, business.industry, General surgery, Reproducibility of Results, Middle Aged, medicine.disease, Pre operative, Single surgeon, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, Cholecystitis, Female, 030211 gastroenterology & hepatology, Surgery, Cholecystectomy, business, Abdominal surgery
Abstract

The prediction of a difficult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Most of the previous literature reported small patient cohorts and have not used an objective measure of operative difficulty. The aim of this study was to develop a pre-operative score to predict difficult cholecystectomy, as defined by a validated intra-operative difficulty grading scale. Two cohorts from prospectively maintained databases of patients who underwent laparoscopic cholecystectomy were analysed: the CholeS Study (8755 patients) and a single surgeon series (4089 patients). Factors potentially predictive of difficulty were correlated to the Nassar intra-operative difficulty scale. A multivariable binary logistic regression analysis was then used to identify factors that were independently associated with difficult laparoscopic cholecystectomy, defined as operative difficulty grades 3 to 5. The resulting model was then converted to a risk score, and validated on both internal and external datasets. Increasing age and ASA classification, male gender, diagnosis of CBD stone or cholecystitis, thick-walled gallbladders, CBD dilation, use of pre-operative ERCP and non-elective operations were found to be significant independent predictors of difficult cases. A risk score based on these factors returned an area under the ROC curve of 0.789 (95% CI 0.773–0.806, p

Published
2019
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2. Corrigendum to Reducing the risk of venous thromboembolism following superficial endovenous treatment: A UK and Republic of Ireland consensus study

Author

Dattani, N, Shalhoub, J, Nandhra, S, Lane, T, Abu-Own, A, Elbasty, A, Jones, A, Duncan, A, Garnham, A, Thapar, A, Murray, A, Saratzis, A, Sharif, A, Huasen, B, Dawkins, C, Nesbitt, C, Carradice, D, Morrow, D, Bosanquet, D, Kavanagh, E, Shaikh, F, Gosi, G, Ambler, G, Fulton, G, Singh, G, Travers, H, Moore, H, Olivier, J, Hitchman, L, O'Donohoe, M, Popplewell, M, Medani, M, Jenkins, M, Goh, MA, Lyons, O, McBride, O, Moxey, P, Stather, P, Burns, P, Forsythe, R, Sam, R, Brar, R, Brightwell, R, Benson, R, Onida, S, Paravastu, S, Lambracos, S, Vallabhaneni, SR, Walsh, S, Aktar, T, Moloney, T, Mzimba, Z, and Nyamekye, I

Subjects
Science & Technology, Peripheral Vascular Disease, Cardiovascular System & Hematology, Cardiovascular System & Cardiology, Surgery, Life Sciences & Biomedicine, 1102 Cardiorespiratory Medicine and Haematology
Published
2020

3. 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

4. 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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5. 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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6. 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. 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., Martin, S. T., Mcdermott, F., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Fahad Ullah, M., 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., 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., 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, J. A., Rajendran, I., Boal, M., and Ritchie, J.

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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7. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruth A. Benson, Maria Antonella Ruffino, Sharon Chan, Patrick Coughlin, Ayoola Awopetu, Philip Stather, Tristan Lane, Dimitrios Theodosiou, Mohamed Abozeid Ahmed, Thodur Vasudevan, Mohammed Ibrahim, Faraj Al Maadany, Mohamed Eljareh, Fatimah Saad Alkhafeefi, Raphael Coscas, Ertekin Utku Ünal, Raffaele Pulli, Sergio Zacà, Domenico Angiletta, Thomas Kotsis, Magdy Moawad, Matteo Tozzi, Nikolaos Patelis, Andreas M. Lazaris, Jason Chuen, Alexander Croo, Elpiniki Tsolaki, Gladiol Zenunaj, Dhafer Kamal, Mahmoud MH. Tolba, Martin Maresch, Vipul Khetarpaul, Joseph Mills, Gaurav Gangwani, Mohamed Elahwal, Rana Khalil, Mohammed A. Azab, Anver Mahomed, Richard Whiston, Ummul Contractor, Davide Esposito, Carlo Pratesi, Elena Giacomelli, Martín Veras Troncoso, Stephane Elkouri, Flavia Gentile Johansson, Ilias Dodos, Marie Benezit, José Vidoedo, João Rocha-Neves, António Henrique Pereira-Neves, Marina Felicidade Dias-Neto, Ana Filipa Campos Jácome, Luis Loureiro, Ivone Silva, Rodrigo Garza-Herrera, Victor Canata, Charlotte Bezard, Kathryn Bowser, Jorge Felipe Tobar, Carlos Gomez Vera, Carolina Salinas Parra, Eugenia Lopez, Yvis Gadelha Serra, Juan Varela, Vanessa Rubio, Gerardo Victoria, Adam Johnson, Leigh Ann O’Banion, Ragai Makar, Tamer Ghatwary Tantawy, Martin Storck, Vincent Jongkind, Orwa falah, Olivia McBride, Arda Isik, Athanasios Papaioannou, Paulo Eduardo Ocke Reis, Umberto Marcello Bracale, Ellie Atkins, Giovanni Tinelli, Emma Scott, Lucy Wales, Ashwin Sivaharan, Georgia Priona, Craig Nesbitt, Tabitha Grainger, Lauren Shelmerdine, Patrick Chong, Adnan Bajwa, Luke Arwynck, Nancy Hadjievangelou, Ahmed Elbasty, Oscar Rubio, Michael Ricardo, Jorge H. Ulloa, Marcos Tarazona, Manuel Pabon, Georgios Pitoulias, Kevin Corless, Orestis Ioannidis, Oliver Friedrich, Isabelle Van Herzeele, Badri Vijaynagar, Tina Cohnert, Rachel Bell, Hayley Moore, Prakash Saha, Edward Gifford, Matti Laine, Adel Barkat, Christos Karkos, Lenny Suryani Binti Safri, Gabriel Buitron, Javier Del Castillo, Paul Carrera, Nilson Salinas, Rodrigo Bruno Biagioni, Sergio Benites, César Andrés Mafla, Putera Mas Pian, Pereira Albino, Ernesto Serrano, Andres Marin, Marco González, Marsha Foreroga, Alejandro Russo, Andrés Reyes, Daniel Guglielmone, Lorena Grillo, Ronald Flumignan, Francisco Gomez Palones, Pierre Galvagni Silveira, Rosnelifaizur Bin Ramely, Sara Edeiken, Ian Chetter, Lucy Green, Abhilash Sudarsanam, Oliver Lyons, Gary Lemmon, Richard Neville, Mariano Castelli, Carlos A. Hinojosa, Rubén Rodríguez Carvajal, Aksim Rivera, Peng Wong, Laura Drudi, Jeremy Perkins, Kishore Sieunarine, Doaa Attia, Mahmoud Atef, Lostoridis Eftychios, Fred Weaver, Leong Chuo Ren, Mohannad Alomari, Reda Jamjoom, Qusai Aljarrah, Ayman Abbas, Faris Alomran, Ambrish Kumar, Abdulmajeed Altoijri, Kareem T. ElSanhoury, Ahmed Alhumaid, Tamer Fekry, Raghuram Sekhar, Panagiotis Theodoridis, Theodoridis Panagiotis, Konstantinos Roditis, Paraskevi Tsiantoula, Afroditi Antoniou, Raphael Soler, Natasha Hasemaki, Efstratia Baili, Eustratia Mpaili, Bella Huasen, Tom Wallace, Andrew Duncan, Matthew Metcalfe, Kristyn Mannoia, Carlos F. Bechara, Nikolaos Tsilimparis, Nathan Aranson, David Riding, Mariano Palena, Ciarán McDonnell, Nicolas J. Mouawad, Shonda Banegas, Peter Rossi, Taohid Oshodi, Rodney Diaz, Rana Afifi, Shiva Dindyal, Ankur Thapar, Ali Kordzadeh, Gonzalo Pullas, Stephanie Lin, Chris Davies, Katy Darvall, Akio Kodama, Thushan Gooneratne, Nalaka Gunawansa, Alberto Munoz, Ng Jun Jie, Nicholas Bradley, Wissam Al-Jundi, Felicity Meyer, Cheong Lee, Martin Malina, Sophie Renton, Dennis Lui, Andrew Batchelder, Grzegorz Oszkinis, Antonio Freyrie, Jacopo Giordano, Nikolaos Saratzis, Konstantinos Tigkiropoulos, Stavridis Kyriakos, Guriy Popov, Muhammad Usman Cheema, Pierfrancesco Lapolla, Yih Chun Ling Patricia, Raed Ennab, Brant W. Ullery, Ketino Pasenidou, Jacky Tam, Gabriel Sidel, Vivek Vardhan Jayaprakash, Lisa Bennett, Simon Hardy, Emma Davies, Sara Baker, Lasantha Wijesinghe, Adam Tam, Ken McCune, Manik Chana, Chris Lowe, Aaron Goh, Katarzyna Powezka, Ioanna Kyrou, Nishath Altaf, Denis Harkin, Hannah Travers, James Cragg, Atif sharif, Tasleem Akhtar, José Antonio Chávez, Claudia Ordonez, Martin Mazzurco, Edward Choke, Imran Asghar, Virginia Summerour, Paul Dunlop, Rachel Morley, Thomas Hardy, Paul Bevis, Robert Cuff, Konstantinos Stavroulakis, Efthymios Beropoulis, Angeliki Argyriou, Ian Loftus, Bilal Azhar, Sharvil Sheth, Marco Virgilio Usai, Asad Choudhry, Kira Nicole, Emily Boyle, Doireann Joyce, Mohammed Hassan Abdelaty Hassan, Alberto Saltiel, Gert Frahm-Jensen, George Antoniou, Muhammed Elhadi, Ali Kimyaghalam, Rafael Malgor, Leigh Ann O'Banion, Diego Telve, Andrej Isaak, Jürg Schmidli, Kevin McKevitt, Tam Siddiqui, Giuseppe Asciutto, Nikolaos Floros, George Papadopoulos, Alexandros Kafetzakis, Stylianos G. Koutsias, Petroula Nana, Athanasios Giannoukas, Stavros Kakkos, Konstantinos G. Moulakakis, Natasha Shafique, Arkadiusz Jawien, Matthew Popplewell, Chris Imray, Kumar Abayasekara, Timothy Rowlands, Ganesh Kuhan, Sriram Rajagopalan, Anthony Jaipersad, Uzma Sadia, Isaac Kobe, Devender Mittapalli, Ibrahim Enemosah, Christian-Alexander Behrendt, Adam Beck, Muayyad Almudhafer, Stefano Ancetti, Donald Jacobs, Priya Jayakumar, Fatemeh Malekpour, Sherene Shalhub, Boboyor Keldiyorov, Meryl Simon, Manar Khashram, Nicole Rich, Amanda Shepherd, Lewis Meecham, Daniel Doherty, Surgery, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Benson, Ruth A, Bracale, Umberto Marcello, Ruffino M.A., Chan S., Coughlin P., Awopetu A., Stather P., Lane T., Theodosiou D., Ahmed M.A., Vasudevan T., Ibrahim M., Al Maadany F., Eljareh M., Alkhafeefi F.S., Coscas R., Unal E.U., Pulli R., Zaca S., Angiletta D., Kotsis T., Moawad M., Tozzi M., Patelis N., Lazaris A.M., Chuen J., Croo A., Tsolaki E., Zenunaj G., Kamal D., Tolba M.M., Maresch M., Khetarpaul V., Mills J., Gangwani G., Elahwal M., Khalil R., Azab M.A., Mahomed A., Whiston R., Contractor U., Esposito D., Pratesi C., Giacomelli E., Troncoso M.V., Elkouri S., Johansson F.G., Dodos I., Benezit M., Vidoedo J., Rocha-Neves J., Pereira-Neves A.H., Dias-Neto M.F., Campos Jacome A.F., Loureiro L., Silva I., Garza-Herrera R., Canata V., Bezard C., Bowser K., Tobar J.F., Vera C.G., Parra C.S., Lopez E., Serra Y.G., Varela J., Rubio V., Victoria G., Johnson A., O'Banion L.A., Makar R., Tantawy T.G., Storck M., Jongkind V., falah O., McBride O., Isik A., Papaioannou A., Ocke Reis P.E., Bracale U.M., Atkins E., Tinelli G., Scott E., Wales L., Sivaharan A., Priona G., Nesbitt C., Grainger T., Shelmerdine L., Chong P., Bajwa A., Arwynck L., Hadjievangelou N., Elbasty A., Rubio O., Ricardo M., Ulloa J.H., Tarazona M., Pabon M., Pitoulias G., Corless K., Ioannidis O., Friedrich O., Van Herzeele I., Vijaynagar B., Cohnert T., Bell R., Moore H., Saha P., Gifford E., Laine M., Barkat A., Karkos C., Binti Safri L.S., Buitron G., Del Castillo J., Carrera P., Salinas N., Biagioni R.B., Benites S., Mafla C.A., Pian P.M., Albino P., Serrano E., Marin A., Gonzalez M., Foreroga M., Russo A., Reyes A., Guglielmone D., Grillo L., Flumignan R., Palones F.G., Silveira P.G., Ramely R.B., Edeiken S., Chetter I., Green L., Sudarsanam A., Lyons O., Lemmon G., Neville R., Castelli M., Hinojosa C.A., Carvajal R.R., Rivera A., Wong P., Drudi L., Perkins J., Sieunarine K., Attia D., Atef M., Eftychios L., Weaver F., Ren L.C., Alomari M., Jamjoom R., Aljarrah Q., Abbas A., Alomran F., Kumar A., Altoijri A., ElSanhoury K.T., Alhumaid A., Fekry T., Sekhar R., Theodoridis P., Panagiotis T., Roditis K., Tsiantoula P., Antoniou A., Soler R., Hasemaki N., Baili E., Mpaili E., Huasen B., Wallace T., Duncan A., Metcalfe M., Mannoia K., Bechara C.F., Tsilimparis N., Aranson N., Riding D., Palena M., McDonnell C., Mouawad N.J., Banegas S., Rossi P., Oshodi T., Diaz R., Afifi R., Dindyal S., Thapar A., Kordzadeh A., Pullas G., Lin S., Davies C., Darvall K., Kodama A., Gooneratne T., Gunawansa N., Munoz A., Jie N.J., Bradley N., Al-Jundi W., Meyer F., Lee C., Malina M., Renton S., Lui D., Batchelder A., Oszkinis G., Freyrie A., Giordano J., Saratzis N., Tigkiropoulos K., Kyriakos S., Popov G., Cheema M.U., Lapolla P., Ling Patricia Y.C., Ennab R., Ullery B.W., Pasenidou K., Tam J., Sidel G., Jayaprakash V.V., Bennett L., Hardy S., Davies E., Baker S., Wijesinghe L., Tam A., McCune K., Chana M., Lowe C., Goh A., Powezka K., Kyrou I., Altaf N., Harkin D., Travers H., Cragg J., sharif A., Akhtar T., Chavez J.A., Ordonez C., Mazzurco M., Choke E., Asghar I., Summerour V., Dunlop P., Morley R., Hardy T., Bevis P., Cuff R., Stavroulakis K., Beropoulis E., Argyriou A., Loftus I., Azhar B., Sheth S., Usai M.V., Choudhry A., Nicole K., Boyle E., Joyce D., Abdelaty Hassan M.H., Saltiel A., Frahm-Jensen G., Antoniou G., Elhadi M., Kimyaghalam A., Malgor R., Telve D., Isaak A., Schmidli J., McKevitt K., Siddiqui T., Asciutto G., Floros N., Papadopoulos G., Kafetzakis A., Koutsias S.G., Nana P., Giannoukas A., Kakkos S., Moulakakis K.G., Shafique N., Jawien A., Popplewell M., Imray C., Abayasekara K., Rowlands T., Kuhan G., Rajagopalan S., Jaipersad A., Sadia U., Kobe I., Mittapalli D., Enemosah I., Behrendt C.-A., Beck A., Almudhafer M., Ancetti S., Jacobs D., Jayakumar P., Malekpour F., Shalhub S., Keldiyorov B., Simon M., Khashram M., Rich N., Shepherd A., Meecham L., Doherty D., and Benson R.A.

Subjects
Vascular surgery, Peripheral artery disease, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Abdominal aortic aneurysm, COVID-19, 610 Medicine & health, Surgery, AAA, Cardiology and Cardiovascular Medicine, Survey, Settore MED/22 - CHIRURGIA VASCOLARE, PAD
Abstract

OBJECTIVE To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. METHODS An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. RESULTS The impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. CONCLUSION Centres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022
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