Abstract：
INTRODUCTION:Despite an increasing emphasis on data-driven quality improvement, few validated quality indicators for emergency surgical services have been published. The aims of this study therefore were: 1) to investigate whether the acute cholecystectomy rate is a valid process indicator; and 2) to use this rate to examine variation in the provision of acute cholecystectomy in England. MATERIALS AND METHODS:The Surgical Workload and Outcomes Research Database (SWORD), derived from the Hospital Episode Statistics database, was interrogated for the 2012-2017 financial years. All adult patients admitted with acute biliary pancreatitis, cholecystitis or biliary colic to hospitals in England were included and the acute cholecystectomy rate in each one examined. RESULTS:A total of 328,789 patients were included, of whom 42,642 (12.9%) underwent an acute cholecystectomy. The acute cholecystectomy rate varied significantly between hospitals, with the overall rate ranging from 1.2% to 36.5%. This variation was consistent across all disease groupings and time periods, and was independent of the annual number of procedures performed by each NHS trust. In 41 (29.9%) trusts, fewer than one in ten patients with acute gallbladder disease underwent cholecystectomy within two weeks. CONCLUSIONS:The acute cholecystectomy rate is easily measurable using routine administrative datasets, modifiable by local services and has a strong evidence base linking it to patient outcomes. We therefore advocate that it is an ideal process indicator that should be used in quality monitoring and improvement. Using it, we identified significant variation in the quality of care for acute biliary disease in England.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Palser TR,Navarro AP,Swift S,Beckingham IJdoi
10.1308/rcsann.2019.0042subject
Has Abstractpub_date
2019-07-01 00:00:00pages
422-427issue
6eissn
0035-8843issn
1478-7083journal_volume
101pub_type
杂志文章abstract：:During the past 10 years of civil unrest in Northern Ireland a wide variety of facial injuries have been treated at the Royal Victoria Hospital, Belfast. The causes and nature of these injuries are described and the experience gained in their management is reviewed. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:Isaac Newton, among others, observed that 'we see so far because we are standing upon the shoulders of giants'. In vascular surgery most of the giants have been European, and this is a heritage which we as Europeans can take pride in and build upon if we chose to do so. As in other areas of life, commitment is essenti...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 历史文章,杂志文章
doi：
更新日期：1999-09-01 00:00:00
abstract：:Introduction Angiolipoma is a histological variant of lipoma and is the most common neoplasm in the trunk and extremities of young adults. It is extremely rare in elderly people, and its size is ≤4cm. Few data are available for large angiolipomas. Case History An 86-year-old patient was admitted to our surgical depart...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2016.0150
更新日期：2016-07-01 00:00:00
abstract：:In a 6-month prospective study of management of surgical emergencies in a district general hospital, we have tried firstly to determine the degree to which non-life-threatening emergencies could be managed within 'social hours' (0800-1800), and secondly to identify examples of and reasons for potentially hazardous del...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:Intestinal fistulae have been outlined using the delayed phase of Tc-99m labelled HIDA. The technique involved is simple, safe and easily reproducible. This method has advantages over conventional radiography particularly for the leaking duodenal stump and involves minimal disturbance to the patient. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1985-09-01 00:00:00
abstract：:Internal herniation of the small bowel through a defect in the falciform ligament and subsequent small bowel obstruction is exceedingly rare with the majority of previous cases being attributed to congenital abnormalities. As laparoscopic techniques approach the forefront of modern surgery, an iatrogenic source for a ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2015.0022
更新日期：2015-09-01 00:00:00
abstract：:A prospective controlled randomised study has been performed of 100 consecutive patients undergoing varicose vein surgery. One group underwent saphenofemoral flush ligation and multiple lower leg avulsions with the leg exsanguinated with a Rhys-Davies cuff, and ischaemia maintained with a pneumatic tourniquet. The oth...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-03-01 00:00:00
abstract：:John Hunter's many contributions to surgery include the development of the scientific approach and possibly the first use of evidence-based medicine. This oration, concentrates on two other areas ? first, some of his contributions to orthopaedics and secondly past, present and future surgical training and competence. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 传,历史文章
doi：10.1308/147870805x28154
更新日期：2005-05-01 00:00:00
abstract：:Over 90% of patients referred to surgeons for investigation of rectal bleeding have haemorrhoids, fissure-in-ano or proctitis. Full investigation of these patients to exclude colonic neoplasia or inflammatory bowel disease imposes a considerable load on a hospital's resources as well as exposing the patient to signifi...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1998-03-01 00:00:00
abstract：AIM:To identify what proportion of patients who, having sustained an initial distal radial fragility fracture and a subsequent femoral neck fracture, had had their osteoporosis addressed in the interval between the two events. PATIENTS AND METHODS:The hospital electronic information system was used to identify all pat...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/147870804371
更新日期：2004-09-01 00:00:00
abstract：:Endoscopic transthoracic sympathectomy (ETS) has recently become established as a successful treatment for severe palmar and axillary hyperhidrosis. In this unit the indications for ETS have been broadened to include patients with Raynaud's syndrome and critical upper limb ischaemia and this paper is primarily concern...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：:A randomised, double-blind study was conducted to assess the influence of intra-articular and subcutaneous prilocaine with adrenaline on postoperative pain in day case arthroscopy of the knee. The time to first dose of oral analgesia postoperatively was significantly prolonged in those patients receiving prilocaine bu...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-11-01 00:00:00
abstract：INTRODUCTION:The Improving Outcomes Guidance (IOG) for patients with carcinoma of the penis states that treatment should be provided supraregionally to populations of 4 million or greater who treat over 25 cases of penis cancer each year. This study assesses the impact of this guidance on the management and outcomes of...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588410X12518836439047
更新日期：2010-01-01 00:00:00
abstract：:Malignant peripheral nerve sheath tumours (MPNSTs) are a rare but aggressive form of soft tissue sarcoma with few reported cases in the anatomic location seen with the case presented here. This case involves a 23-year-old man presenting with a soft tissue mass under the mandible found to be a MPNST, which was investig...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0060
更新日期：2017-05-01 00:00:00
abstract：:John Hunter's observations on dental caries are described and various early speculative theories of its nature and causation are mentioned. With the demonstration in the late 19th century of the chemicoparasitic nature of the late 19th century of the chemicoparasitic nature of the disease attention focused on dietary ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 历史文章,杂志文章
doi：
更新日期：1982-11-01 00:00:00
abstract：:Although the operating microscope was introduced more than 50 years ago, its use was at first confined to otolaryngology and, later, to ophthalmology. More recently its use in the development of microvascular techniques has led to spectacular advances in the field of replantation and reconstructive surgery. The organi...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 历史文章,杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:Primary hyperparathyroidism may be cured surgically by complete excision of abnormal parathyroid tissue. Reoperation for persistent hypercalcaemia due to residual abnormal parathyroid tissue may be associated with a high complication rate. It is possible to assay intact parathormone (iPTH) intraoperatively and as iPTH...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:A series of 21 patients (18 female) whose intractable constipation was treated by colectomy between 1976 and 1985 is reported. There was no mortality attributable to surgery in this series. Total colectomy with ileorectal anastomosis was the preferred operation, but it produced a satisfactory result in only 12 patient...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：BACKGROUND:Giant-cell tumour of the distal radius is a rare neoplasm that affects the peri-articular metaphysial region of the bone. Curettage alone or with bone grafting has been reported to be associated with high incidence of local recurrence in these tumours. In the present series, we report the results of curettag...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588404772614632
更新日期：2004-01-01 00:00:00
abstract：:The pattern of preoperative investigation was audited in 256 patients entering hospital for elective surgery over a 12-week period. During the initial 6 weeks (phase one), no guidance was given to the house surgeons and the investigations were assessed as being 'indicated' or 'not indicated' according to preset criter...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:Bochdalek hernias rarely contain an intrathoracic kidney, and there are few reports of their operative repair. A woman presented with progressive dyspnoea limiting her quality of life. Imaging showed a Bochdalek hernia containing omentum, large bowel and the left kidney. The woman was unexpectedly admitted to the inte...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2020.0190
更新日期：2021-01-01 00:00:00
abstract：:The risk of venous thromboembolism increases during pregnancy and postpartum. The incidence in the first six weeks following delivery is approximately 0.15%. Deep vein thrombosis may present with acute appendicitis-like symptoms such as right iliac fossa pain, nausea and vomiting. A 22-year-old woman was admitted with...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2020.0148
更新日期：2020-11-01 00:00:00
abstract：INTRODUCTION:The aim of this study was to evaluate the level of sharps injury reporting amongst surgeons. SUBJECTS AND METHODS:A total of 164 surgeons completed a questionnaire on the reporting of sharps injuries, on the reasons for not reporting and their practise of universal precautions. RESULTS:Out of 164 surgeon...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588409X432194
更新日期：2009-07-01 00:00:00
abstract：INTRODUCTION:The equivalence of breast-conserving surgery followed by postoperative radiotherapy against mastectomy is now firmly established in patients with early breast cancer. The results of surgery in large-breasted women can be poor, with radiation-induced fibrosis, chronic pain and poor cosmesis contributing to ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588413X13511609958091
更新日期：2013-04-01 00:00:00
abstract：:In the past few years, minimally invasive oesophagectomy has become an increasingly popular approach for oesophagectomy showing advantages in terms of fewer postoperative complications, shorter hospital stay and faster recovery. We present the case of a 60-year-old man with a lesion of the distal third of the oesophag...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2020.0182
更新日期：2021-01-01 00:00:00
abstract：INTRODUCTION:Admission for overnight or longer hospital stay from a day-case unit is an unwelcome event. This audit was designed to identify the incidence of unplanned admissions and also to detect the potential factors for such overstays. PATIENTS AND METHODS:Details of plastic surgical day-case patients were obtaine...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588405X60560
更新日期：2005-11-01 00:00:00
abstract：INTRODUCTION:Safe and effective haemostasis in surgery is clearly essential, and in the neck where risks of airway compromise are also present any new technology that purports to offer advantages must be rigorously evaluated. We describe our experience with the use of the Harmonic Scalpel [Ethicon UK] in thyroidectomy....
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588409X391811
更新日期：2009-04-01 00:00:00
abstract：:In a waiting list initiative scheme 566 operations were performed on 447 patients in 104 sessions over a period of six months. In addition the names of 78 other patients were deleted from the waiting list. Special attention was paid to pre-operative education and assessment of patients by information sheets and 'quest...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:Thoracobilia and pleurobiliary fistulae secondary to obstructed choledocholithiasis are rare complications of gallstone disease. We present the case of a 64-year-old man with gallstone pancreatitis who developed a pleurobiliary fistula secondary to an obstructing ductal calculus, and was successfully managed non-opera...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/147870810X12659688851951
更新日期：2010-07-01 00:00:00
abstract：:The three main risk factors for cardiovascular disease, smoking, hypertension, and hyperlipidaemia, are examined in the light of changing world trends and the mechanisms by which they aggravate this large group of conditions. Prostaglandin activity within the vessel wall and the blood platelets may be disturbed by the...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
