Hospital Italiano De Buenos Aires Research Articles

Impact of the volume of blood collected by phlebotomy on transfusion requirements in preterm infants with birth weight of less than 1500 g. A quasi-experimental study.

Anemia is a complication in very low birth weight (VLBW) infants, and lab tests are a predominant risk factor. At least one red blood cell transfusion is given in more than 50 % of cases. Transfusions are associated with a higher risk for infections, intracranial hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia. In 2012, Hospital Italiano de Buenos Aires implemented a strategy to collect a lower blood volume by phlebotomy. The objective of this study was to assess its association with the number of transfusions. Before-and-after, quasi-experimental study. The number of transfusions was compared between two groups of VLBW preterm infants with different blood collection volumes. The correlation between the collection volume and the number of transfusions was assessed estimating Spearman's coefficient. A logistic regression model was used to adjust for confounders. The study included 178 patients with a mean gestational age of 29.4 weeks (standard deviation: 2.7) and a birth weight of 1145 g (875-1345). The baseline red series profile was similar between both groups. The number of transfusions (p = 0.017) and the transfusion volume (p = 0.048) decreased significantly. The correlation coefficient was 0.83. In the multivariate analysis, collection volume and birth weight were associated with a requirement of more than three transfusions. A lower blood collection volume in VLBW preterm infants is independently associated with fewer transfusion requirements.

Renal fossa recurrence after radical nephrectomy: Current management, and oncological outcomes

Introduction and objectivesKidney cancers represent 2% of cancers worldwide; the most common type is renal clear cell carcinoma (RCC). Surgical treatment remains the only effective therapy for localized renal cell carcinoma. Approximately 20% to 38% of patients undergoing radical nephrectomy (RN) for localized RCC will have subsequent disease progression, with 0.8% to 3.6% of local recurrences within the ipsilateral retroperitoneum (RFR). The main objective of this study is to evaluate prognostic features, oncological outcomes, and current management for renal fossa recurrence in patients with history of RN for RCC. Materials and methodsWe retrospectively analyzed 733 patients who underwent open or laparoscopic RN for unilateral T1-T4 N0 M0 RCC between 2010 and 2016 at the Urology Department of Hospital Italiano de Buenos Aires. ResultsDuring the mentioned period, of a total of 733 RNs (open/laparoscopic), 561 patients with RCC were included in the study. After a median follow-up time of 24 months (12–36) (interquartile range), 21 (3.74%) patients out of 561, developed renal fossa recurrence. Of these, 13 (2.31%) patients were diagnosed with isolated local renal fossa recurrence and different treatment approaches were adopted; 11 patients underwent open surgical resection, 1 patient laparoscopic surgical resection, and 1 case was treated with cryoablation.Regarding cancer-specific survival, estimated 4-year cancer-specific survival in patients without RFR, with isolated RFR (iRFR) and not isolated RFR (niRFR) was 82.7% (CI 95% 70.2–95.2), 69.2% (IC 44.2–94.2) and 0%, respectively (log rank test P < 0.0001 being niRFR group different to others. Non isolated RFR was a death risk factor with a HR of 11.4 (4.8–27.2) compared with iRFR or no recurrence. Overall, 51% (IC 26.6–71.2) of patients with any RFR died at 4 years follow-up. ConclusionAlthough RFR is a rare condition, in the absence of distant metastatic disease, aggressive surgical resection should be our aim. High pathological tumoral stage at original nephrectomy and high tumoral grade are independent risk factors for RFR. This group of patients needs closer follow-up to detect earlier recurrences and decide a treatment strategy.

An Information Retrieval Approach to ICD-10 Classification.

ICD-10 (International Classification of Diseases 10th revision) is a classification code for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. This paper describes an automatic information retrieval approach to map free-text disease descriptions to ICD-10 codes. We use the Hospital Italiano de Buenos Aires (HIBA) terminology data mapped to ICD-10 codes as indexed data to find an appropriate ICD-10 code using search engine similarity metrics.

Implementation of an Inpatient Portal Integrated to an EHR: First Stage Evaluation.

Technology has led to the communication of the hospitalized patient and their family with clinical knowledge. The objective of this study is to describe the rate of use of the Inpatient Personal Health Record of Hospital Italiano de Buenos Aires. A cross-sectional study was conducted between May and September of 2018. The rate of use was 2.10% (95% CI 1.89-2.32). The most used functionalities were analyzed. New strategies are needed to improve the rate of use.

Fetal exposure to bisphenol A: Presence of bisphenol A in urine of pregnant women assisted in a hospital in the City of Buenos Aires. Year 2013.

Bisphenol A (BPA) is an endocrine disruptor (ED) possibly linked to adverse reproductive and neurodevelopmental effects that is used as an additive in food and beverage containers. There are no data of BPA levels in the Argentine population. The objective of this study was to measure BPA in the urine of pregnant women. Cross-sectional study. Detection of BPA in pregnant women of the Hospital Italiano de Buenos Aires in 2013, using gas chromatography and mass spectrometry with a limit of quantification of 2 ng / ml and detection of 0.8 ng / ml. The proportion of women exposed to BPA within the 95% confidence interval (IC 95%) is described. 149 pregnant women, average age 32 years (Standard Deviation 5.3), 81% (95% CI 73.9-86.9) workers and 83.7% (95% CI 76.7-89.1) have university or higher education, 66.4% (95% CI 58-74.0) of the urinary samples were quantifiable, with a median BPA of 4.3 ng/mg Cr (RI 3.2-6.7). This study shows that exposure to BPA during the process of embryonic development in a sector of the population of Argentina is widespread. In Argentina, the use of this ED is only regulated in baby bottles.

DOZ047.85: Percutaneous tracheostomy guided by endoscopy in pediatric patients

Abstract Objective Tracheostomy is one of the most frequently performed surgical procedures in chronically ill pediatric patients and mechanical ventilatory assistance. This study presents our experience in percutaneous tracheostomy (PT) guided by endoscopy in children. Methodology A retrospective descriptive analysis was carried out in which the PT guided by endoscopy from December 2010 to October 2017 at Pediatric Surgery Service of the Hospital Italiano de Buenos Aires were considered. The variables analyzed were age, gender, basic pathology, tracheostomy indication, size of the cannula placed, surgical complications, and follow-up. At the same time, an updated bibliographical search on the subject was carried out. All the parents of the patients gave written consent. Results and Discussion A total of 50 PT guided by endoscopy were performed. The average age was 9.4 years (05–19 years). The male/female ratio was 1 (25 men, 25 women). The tracheostomy indications were prolonged orotracheal intubation (n: 41), lack of airway protection (n: 4), laryngomalacia (n: 2), difficult airway (n: 2), and laryngotracheal stenosis (n: 1). The endoscopic findings include glottic lesion, subglottic stenosis, vocal cord injury, and tracheal lesions by decubitus. There were no intraoperative complications. The average surgical time was 44 minutes (r: 10–60 min). The rate of postoperative complications was 6% (n: 3), among which were accidental decannulation, desaturation, and leakage. Distant complications such as tracheitis or granulomas occurred in 8% of patients (n: 4). The definitive decannulation was achieved in 19 patients in an average time of 15 days. Conclusions PT is feasible in children with a margin of safety comparable to tracheostomy by conventional technique. Simultaneous endoscopic vision is recommended for the control of complications during the procedure, in part because it offers firmness to the anterior wall of the trachea. At the same time it allows us to diagnose preexisting laryngotracheal lesions or anomalies. The size of the tracheostomy kit should be adjusted to the age of the patient to perform a safe tracheostomy. Due to the small diameter of the trachea and its weakness, it is not recommended by us to perform percutaneous tracheostomy in patients under 2 years of age.

Nonattendance rates of scheduled outpatient appointments in a university general hospital.

We aimed to estimate nonattendance to scheduled medical ambulatory appointments rates globally and by subgroups. We designed a retrospective cohort of all adult outpatients over 18years old who requested at least one scheduled ambulatory medical appointment from 1 January 2015 to 31 December 2016. Hospital Italiano de Buenos Aires is a university general hospital in the Autonomous City of Buenos Aires, Argentina. It includes an integrated health care network that is formed by two high complexity hospitals and 22 primary care centers. The age median was 60.4years, and 31.33% of the appointments were scheduled by men; 2526549 appointments fulfilled selection criteria, belonging to 348420 patients. The global nonattendance rate was 27.84% (95% CI, 27.79-27.9). The nonattendance rate to general practitioner appointments was 25.53% (95% CI, 25.42-25.63); to clinical specialties, 27.78% (95% CI, 27.68-27.87); and to surgical specialties, 29.31% (95% CI, 29.23-29.4). Because of the consistent variability of nonattendance in different settings, it is strongly recommended that local estimates are used in the design of effective interventions to improve adherence with outpatient healthcare scheduled appointments.

Cryoprobe biopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin.

Acute hypoxemic respiratory failure is a condition that comprises a wide array of entities. Obtaining a histological lung sample might help reach a diagnosis and direct an appropriate treatment in a select group of patients. To describe our experience in the use of cryobiopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin. Retrospective analysis of case series of patients with acute hypoxemic respiratory failure who underwent lung cryobiopsy at the Intensive Care Unit of the Hospital Italiano de Buenos Aires, Argentina. Cryobiopsy yielded a histological diagnosis in all patients (n = 10, 100%). This led to either a change in therapy or continuation of a specific treatment in eight of these patients. Cryobiopsy was found to be contributive in all the patients who did not meet Berlin criteria for acute respiratory distress syndrome. No major complications were associated with the procedure. Cryobiopsy is a safe procedure with a high diagnostic yield in a selected group of patients.

Hidradenitis Suppurativa: Estimated Prevalence, Clinical Features, Concomitant Conditions, and Diagnostic Delay in a University Teaching Hospital in Buenos Aires, Argentina

BackgroundHidradenitis suppurativa is a chronic recurrent systemic inflammatory disease that mainly involves large skin folds. It develops when pilosebaceous units become blocked, leading to the formation of painful nodules, abscesses, fistulas, and scarring. The impact of this disease on quality of life is great. ObjectivesTo describe the prevalence and clinical features of hidradenitis suppurativa in patients treated at Hospital Italiano de Buenos Aires and determine the frequency of comorbidities and time to diagnosis in this population. Material and methodsRetrospective descriptive cross-sectional study. Information was extracted from the computerized clinical records of all patients with a diagnosis of hidradenitis suppurativa managed in Hospital Italiano de Buenos Aires between July 2012 and October 2017. ResultsOur initial search of the records yielded 180 cases; the diagnosis was confirmed in 66 cases. Sixty-five percent of the patients were women, and the mean age was 37 years. The prevalence of this diagnosis was 0.02%.The armpits, vulva, and groin were the locations most frequently affected. Smoking, overweight, and obesity were the most commonly recorded concomitant conditions.Male sex and perianal and gluteal locations were associated with severity.Time until diagnosis varied widely, ranging from diagnosis at the first visit in some cases to as long as 142 months and 21 visits. ConclusionsOur findings are consistent with the literature on hidradenitis suppurativa. This is the first Argentinian study to describe the prevalence of this disease as well as the concomitant conditions found and the rate of diagnostic error.

Hidradenitis supurativa: una aproximación a su prevalencia, características clínicas, comorbilidades y tiempo al diagnóstico, en un hospital universitario de Buenos Aires, Argentina

BackgroundHidradenitis suppurativa is a chronic recurrent systemic inflammatory disease that mainly involves large skin folds. It develops when pilosebaceous units become blocked, leading to the formation of painful nodules, abscesses, fistulas, and scarring. The impact of this disease on quality of life is great. ObjectivesTo describe the prevalence and clinical features of hidradenitis suppurativa in patients treated at Hospital Italiano de Buenos Aires and determine the frequency of comorbidities and time to diagnosis in this population. Material and methodsRetrospective descriptive cross-sectional study. Information was extracted from the computerized clinical records of all patients with a diagnosis of hidradenitis suppurativa managed in Hospital Italiano de Buenos Aires between July 2012 and October 2017. ResultsOur initial search of the records yielded 180 cases; the diagnosis was confirmed in 66 cases. Sixty-five percent of the patients were women, and the mean age was 37 years. The prevalence of this diagnosis was 0.02%.The armpits, vulva, and groin were the locations most frequently affected. Smoking, overweight, and obesity were the most commonly recorded concomitant conditions.Male sex and perianal and gluteal locations were associated with severity.Time until diagnosis varied widely, ranging from diagnosis at the first visit in some cases to as long as 142 months and 21 visits. ConclusionsOur findings are consistent with the literature on hidradenitis suppurativa. This is the first Argentinian study to describe the prevalence of this disease as well as the concomitant conditions found and the rate of diagnostic error.

Donor to Host Transmission of Infection in Lung Transplantation

Purpose To evaluate the incidence and etiology of donor infection and donor to host transmission of infections in lung transplantation. Methods We performed a retrospective cohort study of lung transplant patients at Hospital Italiano de Buenos Aires from January 2010 to March 2017. We analyzed data from electronic medical records. Donor infection was classified as bacteremia, graft colonization or isolated contamination of preservation fluids. Donor-to-host transmission of infection was defined as any infection in the recipient due to at least one microorganism also isolated from the donor and with identical antimicrobial susceptibility pattern. Results We included 55 lung transplant patients. Mean age was 48 years (SD 16), Single lung transplantation was performed in 75% of the cases. Cause of transplantation was chronic obstructive pulmonary disease (n=19), interstitial lung disease (n= 15), cystic fibrosis (n= 16) and others (n=5). Incidence of donor infection was 92.7% (n=51, 95%CI 82-98). Isolated contamination of preservation fluids was determined in 76.4% of cases (n= 42), graft colonization in 83.6% (n= 46) and bacteremia in 12.7% (n=7). The most common microorganisms isolated were gram positive coccus. Incidence of donor to host transmission of infection was 12.7% (n= 7, 95% CI 5-24). All cases were related to graft colonization. 40% (n=3) of recipients that developed infection had inadequate antibiotic prophylaxis. The microbiological etiologies were Acinetobacter baumannii (n=2), Klebsiella pneumoniae (n=2), Citrobacter koseri (n=1), Aspergillus fumigatus (n=1) and Methicillin-Sensitive Staphylococcus Aureus (n=1). Types of host infection were pneumonia (n=5), tracheobronchitis (n=1) and empyema (n=1). Infection-related death occurred in one patient. Conclusion The incidence of donor infection was high but donor to host transmission of infection after lung transplantation was an uncommon event. Inadequate antibiotic prophylaxis was high in those with donor to host transmission of infection. The most frequent etiology for donor infection was gram positive cocci. Gram negative bacteria was the most frequent cause of donor to host transmission of infection.

Terminología clínica: la base para la representación/categorización de la información en las historias clínicas electrónicos del paciente

The objective of this document is to describe the experience of the Department of Health Informatics of the Hospital Italiano de Buenos Aires (HIBA) in the generation of a thesaurus, with the use of Snomed CT as reference vocabulary, and the modifications that it suffered until which became terminological services. To meet this objective we will show the main milestones to show the current functionalities.

Usefulness of minimally invasive spine surgery for the management of thoracolumbar spinal metastases

ResumenObjetivo:Describir los resultados quirúrgicos y evolución de pacientes con metástasis espinales toraco-lumbares operadas con técnica mínimamente invasiva (MISS) utilizando para la decisión terapéutica la evaluación: Neurológica, Oncológica, Mecánica y Sistémica (NOMS).Material y Métodos:Se incluyeron en forma prospectiva pacientes con metástasis espinales toraco-lumbares operados con técnica MISS por el Servicio de Neurocirugía del Hospital Italiano de Buenos Aires entre Junio de 2014 y Junio de 2017. Se utilizó en todos los casos el algoritmo de evaluación NOMS para la decisión terapéutica. Se analizaron los resultados quirúrgicos postoperatorios como el Karnofsky performance status, dolor (VAS – visual analog scale), Frankel, pérdida sanguínea, necesidad de transfusiones, complicaciones, uso de opioides y días de internación. Se consideró como estadísticamente significativo una P < 0.05.Resultados:Durante el período de estudio 26 pacientes cumplieron los criterios de inclusión, de los cuales 13 fueron mujeres. La edad promedio fue 57 (27-83) años. El origen más frecuente de las lesiones fue cáncer de mama (27%). El síntoma más constante fue el dolor (96%), aunque 12 pacientes manifestaron inicialmente mielopatía (46%). Se observaron grados avanzados de invasión del canal con requerimiento de descompresión en el 65% de los casos. Acorde al Spinal Instability Neoplastic Score, 23 pacientes (89%) presentaron lesiones potencialmente inestables o inestables, requiriendo estabilización. Se evidenció una mejoría estadísticamente significativa del VAS en el 77% y del Frankel en el 67% de los casos tras la cirugía. No hubo necesidad de transfusiones. Se registró sólo una complicación quirúrgica leve (4%). La media de internación fue de 5.5 días.Conclusión:En nuestra serie y utilizando como algoritmo terapéutico el NOMS, la cirugía MISS resultó efectiva tanto para la descompresión como para la estabilización espinal, con baja tasa de complicaciones y rápida recuperación postoperatoria.

Spontaneous bacterial peritonitis in patients with cirrhosis: incidence, outcomes, and treatment strategies.

Spontaneous bacterial peritonitis is the most frequent bacterial infection in patients with cirrhosis. The reported incidence varies between 7% and 30% in hospitalized patients with cirrhosis and ascites, representing one of their main complications. Outcomes in patients with spontaneous bacterial peritonitis are poor since acute kidney injury, acute-on-chronic liver failure, and death occur in as much as 54%, 60%, and 40% of the patients, respectively, at midterm. Early antibiotic treatment of spontaneous bacterial peritonitis is crucial. However, the landscape of microbiological resistance is continuously changing, with an increasing spread of multidrug-resistant organisms that make its current management more challenging. Thus, the selection of the empirical antibiotic treatment should be guided by the severity and location where the infection was acquired, the risk factors for multidrug-resistant organisms, and the available information on the local expected bacteriology. The use of albumin as a complementary therapy for selected high-risk patients with spontaneous bacterial peritonitis is recommended in addition to antibiotics. Even though antibiotic prophylaxis has proven to be effective to prevent spontaneous bacterial peritonitis, a careful selection of high-risk candidates is crucial to avoid antibiotic overuse. In this article we review the pathogenesis, risk factors, and prognosis of spontaneous bacterial peritonitis, as well as the current evidence regarding its treatment and prophylaxis.

Preclinical Studies of NEAST (Neutralizing Equine Anti-Shiga To xin): A Potential Treatment for Prevention of Stec-Hus

STEC-HUS is a clinical syndrome characterized by the triad of thrombotic microangiopathy, thrombocytopenia and acute kidney injury. Despite the magnitude of the social and economic problems caused by STEC infections, there are currently no specific therapeutic options on the market. HUS is a toxemic disorder and the therapeutic effect of the early intervention with anti-toxin neutralizing antibodies has been supported in several animal models. We have designed novel protein nanoparticles with very strong immunogenic capacity by inserting Stx1B and Stx2B subunits of Shiga toxin to Brucella abortus Lumazine Synthase (BLS). The chimeric BLS-StxBs particles elicited strong neutralizing antibodies against Shiga toxins in horses. Based on these responses, we produced NEAST (Neutralizing Equine Anti-Shiga Toxin), composed of purified F(ab’)2 fragments. In this report we present the preclinical analysis of this new treatment. As a general conclusion, NEAST shows a very strong neutralizing capacity against 8 Shiga toxin variants in preclinical models of STEC-HUS. NEAST is also able to neutralize pathologic effects after previous exposure to Shiga Toxin, defining a potential therapeutic window. Besides, NEAST shows an excellent pharmacokinetics and safety profile in animal models. Overall, these results indicate that NEAST is a very good drug candidate for preventing the onset of HUS in STEC-infected patients and validate the conduction of a first in human clinical study at the Hospital Italiano de Buenos Aires in order to evaluate its safety and pharmacokinetic profiles in healthy adult volunteers.

¿Un recuento elevado de leucocitos aleja la sospecha de dengue? Aportes al algoritmo diagnóstico

Objetivo: Evaluar la utilidad del recuento leucocitario en pacientes con sospecha de dengue como predictor de ausencia de la enfermedad al momento de la consulta inicial al sistema de salud.&#x0D; Métodos: Estudio analítico de cohorte retrospectiva y test diagnóstico, que incluyó todos los pacientes atendidos en el Hospital Italiano de Buenos Aires entre las SE 1/2015 y 7/2016 por sospecha de dengue, con seguimiento de laboratorio completo hasta confirmar o descartar la enfermedad (según guías argentinas).&#x0D; Resultados: Durante el periodo de estudio fueron atendidos 352 pacientes con sospecha de dengue. Incluimos los 180 pacientes que completaron el seguimiento (58 dengue confirmado, 122 dengue descartado). Edad mediana 37 años (RIC 28-47.5), sexo masculino 51,1% (IC95% 44-58). Entre aquellos con dengue confirmado, 46,6% (IC95% 33-60) eran casos autóctonos. El serotipo predominante fue DEN-1. En 43/45 pacientes con recuento leucocitario inicial ≥ 9000 se descartó el diagnóstico de dengue. El Valor Predictivo Negativo de este punto de corte es de 95,5% (IC95% 84.9-99.5).&#x0D; Conclusiones: Agregar un recuento leucocitario ≥9000 a los algoritmos actuales como criterio para alejar la sospecha de dengue al momento de la primera consulta podría mejorar significativamente el valor predictivo negativo de los mismos. Solo 1 de cada 20 pacientes que presentan recuento de leucocitos ≥ 9000 durante la primera consulta en este contexto tienen diagnóstico confirmado de dengue.

IMPACTO DE DIFERENTES TÉCNICAS BARIÁTRICAS SOBRE EL PERFIL LIPÍDICO EN OBESOS

Introducción: la obesidad es una enfermedad crónica de características epidémicas determinada, entre otras variables, por la interacción de factores genéticos y medioambientales. En pacientes obesos se presenta la dislipemia con un fenotipo aterogénico.La cirugía bariátrica (CB) constituye una alternativa terapéutica eficaz para la disminución del riesgo cardiovascular en tanto mejora el perfil lipídico.Objetivos: comparar las diferencias en el perfil lipídico antes y después de someter a los pacientes del Hospital Italiano de Buenos Aires a dos técnicas distintas de cirugía bariátrica con un seguimiento al año de la intervención.Materiales y métodos: en el presente estudio se incluyeron todos los pacientes sometidos a CB en el año 2015 (n=138) en el Hospital Italiano de Buenos Aires.Resultados: la reducción de los niveles de colesterol total, triglicéridos y LDL así como el aumento de HDL al año de la intervención fueron estadísticamente significativos y no se hallaron diferencias al comparar los deltas de cada variable del perfil lipídico entre dos técnicas quirúrgicas diferentes.Conclusiones: la CB puede constituir un tratamiento efectivo en pacientes obesos con dislipidemia que no respondan a la terapia farmacológica dado que se observan cambios significativos en el perfil lipídico.

Terminología clínica: la base para la representación/categorización de la información en las historias clínicas electrônicos del paciente

El objetivo de este documento es describir la experiencia del Departamento de Informática de la Salud del Hospital Italiano de Buenos Aires (HIBA) en en la generación de un tesauro, con la utilización de Snomed CT como vocabulario de referencia, y las modificaciones que sufrió hasta que se convirtió en servicios terminológicos. Para cumplir con este objetivo mostraremos los hitos principales para mostrar las funcionalidades actuales.

Experiencia en el ámbito de la educación a distancia: de especialista a (y) e magíster en Informática en Salud en el Hospital Italiano de Buenos Aires

El objetivo de este artículo es describir la experiencia del Departamento de Informática en Salud (DIS) del Hospital Italiano de Buenos Aires (HIBA) en educación virtual, a distancia, formando profesionales especialistas en Informática en Salud. Esto implica también la articulación propuesta de posgrado de la maestría en Informática en Salud. Para cumplir con ese objetivo seguiremos una línea de tiempo donde se muestran los principales hitos. Para un mejor entendimiento se dividieron estas instancias en dos, la implementación de una plataforma virtual y posterior desarrollo de cursos virtuales por un lado, y el desarrollo del programa de la residencia, la carrera de especialista y su posterior transformación a una maestría por el otro.

Laparoscopic Transcystic Common Bile Duct Exploration in the Emergency Is as Effective and Safe as in Elective Setting

BackgroundEmergent laparoscopic transcystic common bile duct exploration (LTCBDE) has been reported to be on the increase in some institutions, reflecting the growing confidence with the technique. However, no study has focused on the outcomes of LTCBDE in the non-elective setting. The aim of this study is to investigate whether LTCBDE can be performed effectively and safely in the emergency. MethodsThis is a retrospective study of 500 consecutive patients with choledocholithiasis subjected for LTCBDE at the Hospital Italiano de Buenos Aires from January 2009 to January 2018. Procedures were classified according to the setting as emergent or elective. Demographic data and perioperative parameters were compared between groups. ResultsThroughout the period comprised, 500 patients were admitted for choledocholithiasis and gallstones. A single-step treatment combining LTCBDE and laparoscopic cholecystectomy was attempted: 211 (42.2%) were performed electively and the 289 (57.8%) as an emergency. There was no significant difference in the success rate of LTCBDE (93.9% versus 93.8%, p = 0.975) for the two groups. The operative time was slightly longer in the emergency group (122 ± 63 versus 106 ± 53 min, p = 0.002). Postoperative recovery was slower in the emergency group, as reflected by a higher rate of prolonged postoperative stay (21.1% vs 5.7%, p < .001). The rates of postoperative complications were similar between groups (2.8% vs 5.9%, p = 0.109). ConclusionEmergent LTCBDE can be performed with equivalent efficacy and morbidity when compared to an elective procedure. Patients undergoing emergent procedures have longer procedures and hospital stays.