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Emergency surgery model improves outcomes for patients with acute cholecystitis

To the Editor: Reducing the time from presentation to cholecystectomy in patients with acute cholecystitis has been shown to benefit patients (eg, by reducing the duration of patient discomfort before surgery) and to be cost-effective.13 Benefits have also been shown for performing cholecystectomy during the index admission for gallstone pancreatitis.4

Geelong Hospital (in regional Victoria) introduced daily general surgery emergency theatre sessions in February 2011. We compared 401 patients who presented to the emergency department (ED) with acute cholecystitis from February 2008 to January 2011 (control period) with 137 who presented from February 2011 to January 2012 (intervention period). We also compared patients who presented with gallstone pancreatitis — 91 in the control period and 38 in the intervention period. For patients who underwent cholecystectomy during their index admission, we analysed the time of presentation to the ED and time of surgery. Complication rates (for bile duct injury, bile leak requiring intervention, unplanned endoscopic retrograde cholangiopancreatography, mortality or unplanned reoperation) were analysed by…