Optimal Timing for Interval Cholecystectomy Is Not Dependent Only on Incidence of Intraoperative Complication

Abstract

We read with great interest the article by Woodward and colleagues. 1 Woodward S.G. Rios-Diaz A.J. Zheng R. et al. Finding the most favorable timing for cholecystectomy after percutaneous cholecystostomy tube placement: an analysis of institutional and national data. J Am Coll Surg. 2021; 232: 55-64 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar This study analyzed log-link binomial generalized linear models to account for clustering of outcomes to identify any association between interval from percutaneous cholecystostomy to cholecystectomy and complications using 2,706 patients weighted to represent a national sample of 6,145 patients from the National Readmission Database. They concluded that interval cholecystectomy within 4 weeks is associated with a higher risk of surgical complication and interval cholecystectomy at a 4- to 8-week interval is reasonable. However, there are some issues to be clarified. Nationwide Subanalysis of Patient Profile for Same-Admission vs Post-Discharge Interval Cholecystectomy after Percutaneous Cholecystostomy Tube Placement: In Reply to Sakamoto and LeforJournal of the American College of SurgeonsVol. 233Issue 1PreviewWe received the critique of our article1 from Sakamoto and Lefor and appreciate the feedback. In their letter to the editor, Sakamoto and Lefor identified 3 main points of clarification within our article, with the first questioning the exclusion of patients undergoing cholecystectomy within the same admission of percutaneous cholecystostomy tube (PCT) placement, the second point addressing patients with retained common bile duct stones postoperatively as it relates to PCT timing, and finally, using a linear assumption in analyzing the relationship between surgical complications and duration of PCT. Full-Text PDF