Abstract
Introduction: Patients with symptomatic cholelithiasis may undergo cholecystectomy, as an emergency or elective, in the outpatient clinic after discharge from the emergency department (ED). Increasing waiting times for elective cholecystectomy may lead to multiple ED visits for pain management or admission for emergency cholecystectomy. The aim of our study was to determine the relationship between waiting time for elective cholecystectomy and emergency admission.
Methods: This retrospective, observational study was designed and conducted at a single institution. The medical records of 239 patients with gallstone diseases who underwent emergency or elective cholecystectomy between January 2013 to November 2017 were obtained from the clinic.
Result: Approximately 76% (182/239) of the study participants underwent elective cholecystectomy and similar to 24% (57/239) visited the ED during their waiting period, of which 42% (24/57) proceeded with emergency cholecystectomy during the waiting time for elective cholecystectomy and the remaining 58% (33/57) were managed in the ED and eventually underwent elective cholecystectomy. A waiting period of 60 days or more increased the risk of emergency cholecystectomy 5.21 times compared to a waiting period of less than 60 days. A waiting period of 31 to 180 days and above increased the chances of emergency cholecystectomy 4.13 (risk ratio) times and 25.5 (risk ratio) times, respectively, compared to a waiting period of 30 days or less.
Conclusion: Waiting time for elective cholecystectomy should be less than 30 days to reduce the risk of emergency cholecystectomy and multiple ED visits.