An external audit of laparoscopic cholecystectomy performed in medical treatment facilities of the department of defense

David C. Wherry, Charles G. Rob, Michael Marohn, Norman M. Rich

Research output: Contribution to journalArticle

Abstract

Objective. This study provided an objective survey by an outside auditing group of a large, complete patient population undergoing laparoscopic cholecystectomies, determined the frequency of complications, especially bile duct injuries, and presented a system for classifying and comparing the severity of bile duct injuries. Summary Background Data. This is the first study of laparoscopic cholecystectomy to encompass a large and complete patient population and to be based on objectively collected data rather than self-reported data. The Civilian External Peer Review Program (CEPRP) of the Department of Defense health care system conducted a retrospective study of 5642 patients who underwent laparoscopic cholecystectomies at 89 military medical treatment facilities from July 1990 through May 1992. Methods. The study sample consisted of the complete records of 5607 (99.38%) of the 5642 laparoscopic cholecystectomy patients. Results. Of the sample, 6.87% of patients experienced complications within 30 days of surgery, 0.57% sustained bile duct injuries, and 0.5% sustained bowel injuries. Among 5154 patients whose procedures were completed laparoscopically, 5.47% experienced complications. Laparoscopic procedures were converted to open cholecystectomies in 8.08% of cases. Intraoperative cholangiograms were attempted in 46.5% of cases and completed in 80.59% of those attempts. There were no intraoperative deaths; 0.04% of the patients died within 30 days of surgery. Conclusions. The frequency of complications found in this study is comparable to the frequency of complications reported in recent large civilian studies and earlier, smaller studies. The authors present a system for classifying bile duct injuries, which is designed to standardize references to such injuries and allow for accurate comparison of bile duct injuries in the future.

Original languageEnglish (US)
Pages (from-to)626-634
Number of pages9
JournalAnnals of Surgery
Volume220
Issue number5
StatePublished - Nov 1994
Externally publishedYes

Fingerprint

Laparoscopic Cholecystectomy
Bile Ducts
Wounds and Injuries
Ambulatory Surgical Procedures
Therapeutics
Peer Review
Cholecystectomy
Population
Retrospective Studies
Delivery of Health Care

ASJC Scopus subject areas

  • Surgery

Cite this

An external audit of laparoscopic cholecystectomy performed in medical treatment facilities of the department of defense. / Wherry, David C.; Rob, Charles G.; Marohn, Michael; Rich, Norman M.

In: Annals of Surgery, Vol. 220, No. 5, 11.1994, p. 626-634.

Research output: Contribution to journalArticle

@article{a670cd27d5c444469734d322e0f82666,
title = "An external audit of laparoscopic cholecystectomy performed in medical treatment facilities of the department of defense",
abstract = "Objective. This study provided an objective survey by an outside auditing group of a large, complete patient population undergoing laparoscopic cholecystectomies, determined the frequency of complications, especially bile duct injuries, and presented a system for classifying and comparing the severity of bile duct injuries. Summary Background Data. This is the first study of laparoscopic cholecystectomy to encompass a large and complete patient population and to be based on objectively collected data rather than self-reported data. The Civilian External Peer Review Program (CEPRP) of the Department of Defense health care system conducted a retrospective study of 5642 patients who underwent laparoscopic cholecystectomies at 89 military medical treatment facilities from July 1990 through May 1992. Methods. The study sample consisted of the complete records of 5607 (99.38{\%}) of the 5642 laparoscopic cholecystectomy patients. Results. Of the sample, 6.87{\%} of patients experienced complications within 30 days of surgery, 0.57{\%} sustained bile duct injuries, and 0.5{\%} sustained bowel injuries. Among 5154 patients whose procedures were completed laparoscopically, 5.47{\%} experienced complications. Laparoscopic procedures were converted to open cholecystectomies in 8.08{\%} of cases. Intraoperative cholangiograms were attempted in 46.5{\%} of cases and completed in 80.59{\%} of those attempts. There were no intraoperative deaths; 0.04{\%} of the patients died within 30 days of surgery. Conclusions. The frequency of complications found in this study is comparable to the frequency of complications reported in recent large civilian studies and earlier, smaller studies. The authors present a system for classifying bile duct injuries, which is designed to standardize references to such injuries and allow for accurate comparison of bile duct injuries in the future.",
author = "Wherry, {David C.} and Rob, {Charles G.} and Michael Marohn and Rich, {Norman M.}",
year = "1994",
month = "11",
language = "English (US)",
volume = "220",
pages = "626--634",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - An external audit of laparoscopic cholecystectomy performed in medical treatment facilities of the department of defense

AU - Wherry, David C.

AU - Rob, Charles G.

AU - Marohn, Michael

AU - Rich, Norman M.

PY - 1994/11

Y1 - 1994/11

N2 - Objective. This study provided an objective survey by an outside auditing group of a large, complete patient population undergoing laparoscopic cholecystectomies, determined the frequency of complications, especially bile duct injuries, and presented a system for classifying and comparing the severity of bile duct injuries. Summary Background Data. This is the first study of laparoscopic cholecystectomy to encompass a large and complete patient population and to be based on objectively collected data rather than self-reported data. The Civilian External Peer Review Program (CEPRP) of the Department of Defense health care system conducted a retrospective study of 5642 patients who underwent laparoscopic cholecystectomies at 89 military medical treatment facilities from July 1990 through May 1992. Methods. The study sample consisted of the complete records of 5607 (99.38%) of the 5642 laparoscopic cholecystectomy patients. Results. Of the sample, 6.87% of patients experienced complications within 30 days of surgery, 0.57% sustained bile duct injuries, and 0.5% sustained bowel injuries. Among 5154 patients whose procedures were completed laparoscopically, 5.47% experienced complications. Laparoscopic procedures were converted to open cholecystectomies in 8.08% of cases. Intraoperative cholangiograms were attempted in 46.5% of cases and completed in 80.59% of those attempts. There were no intraoperative deaths; 0.04% of the patients died within 30 days of surgery. Conclusions. The frequency of complications found in this study is comparable to the frequency of complications reported in recent large civilian studies and earlier, smaller studies. The authors present a system for classifying bile duct injuries, which is designed to standardize references to such injuries and allow for accurate comparison of bile duct injuries in the future.

AB - Objective. This study provided an objective survey by an outside auditing group of a large, complete patient population undergoing laparoscopic cholecystectomies, determined the frequency of complications, especially bile duct injuries, and presented a system for classifying and comparing the severity of bile duct injuries. Summary Background Data. This is the first study of laparoscopic cholecystectomy to encompass a large and complete patient population and to be based on objectively collected data rather than self-reported data. The Civilian External Peer Review Program (CEPRP) of the Department of Defense health care system conducted a retrospective study of 5642 patients who underwent laparoscopic cholecystectomies at 89 military medical treatment facilities from July 1990 through May 1992. Methods. The study sample consisted of the complete records of 5607 (99.38%) of the 5642 laparoscopic cholecystectomy patients. Results. Of the sample, 6.87% of patients experienced complications within 30 days of surgery, 0.57% sustained bile duct injuries, and 0.5% sustained bowel injuries. Among 5154 patients whose procedures were completed laparoscopically, 5.47% experienced complications. Laparoscopic procedures were converted to open cholecystectomies in 8.08% of cases. Intraoperative cholangiograms were attempted in 46.5% of cases and completed in 80.59% of those attempts. There were no intraoperative deaths; 0.04% of the patients died within 30 days of surgery. Conclusions. The frequency of complications found in this study is comparable to the frequency of complications reported in recent large civilian studies and earlier, smaller studies. The authors present a system for classifying bile duct injuries, which is designed to standardize references to such injuries and allow for accurate comparison of bile duct injuries in the future.

UR - http://www.scopus.com/inward/record.url?scp=0028019824&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028019824&partnerID=8YFLogxK

M3 - Article

C2 - 7979610

AN - SCOPUS:0028019824

VL - 220

SP - 626

EP - 634

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 5

ER -