Abstract
This study aims to explore how timing of interval of cholecystectomy (IC) after percutaneous transhepatic cholecystostomy tube (PTC) placement impacts post-operative outcomes. A retrospective database analysis of New York State SPARCs database of IC between 2005 and 2015. The timing forIC ranged between > 1week and < 2years. Patients undergoing this procedurewere further divided into quartiles using 4-time intervals; 1-5weeks (Q1), 5-8weeks (Q2), 8-12weeks(Q3), and > 12weeks(Q4). The study's primary outcome was hospital length of stay (LOS). Secondary outcomes included discharge status, 30-day readmission, 30-day ED visit, and 90-day reoperation, surgery type, complication, and bile duct injury. Multivariable regression models were used to compare patients across the four-time intervals after adjusting for confounding factors. A total of 1038 patients with a history of PTC followed by IC between > 1week and < 2years were included in the final analysis. The median time to IC was 7.7weeks. Q2 and Q3 both had a significantly higher median LOS of 3days versus Q1 and Q4 at median of 5days (p < 0.0001). Patients from racial and ethnic minorities (e.g., African Americans and Hispanics) were more likely to get their IC after 12weeks (p < 0.05). Further, Black patients had a significantly higher median LOS than White, non-Hispanic patients (8days vs 4days, p < 0.0001) and were more likely to have open procedure. Multivariable regression analysis identified shorter LOS during Q2 (Ratio, 0.76, 95%, 0.67-0.87, p < 0.0001), and Q3 (Ratio 0.75, 95% CI, 065-0.86, p < 0.0001) compared to those who got their IC in Q4. Similar findings exist when comparing Q2 and Q3 to those receiving treatment during Q1. A time interval of 5-12weeks between PTC and IC was associated with a decreased LOS. This study also suggests the persistence of racial disparities among these patients.
Published Version
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