An audit of medical outliers in a north Wales district ­general hospital

2017 ◽  
Vol 4 (Suppl 2) ◽  
pp. s13-s13 ◽  
Author(s):  
Hayley Evans ◽  
Vedamurthy Adhiyaman
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
North Wales

scholarly journals Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

2021 ◽  
pp. 175045892097741
Author(s):  
Zoe Hinchcliffe ◽  
Imran Mohamed ◽  
Anil Lala
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Hospital ◽  
Univariate Analysis ◽  
District General Hospital ◽  
Day Case ◽  
Patient Factors ◽  
Surgical Services ◽  
North Wales ◽  
Selection For ◽  
The Uk

Background The UK practice of laparoscopic cholecystectomy has reduced during the COVID-19 pandemic due to cancellation of non-urgent operations. Isolated day-case units have been recommended as ‘COVID-cold’ operating sites to resume surgical procedures. This study aims to identify patients suitable for day case laparoscopic cholecystectomy (DCLC) at isolated units by investigating patient factors and unexpected admission. Method Retrospective analysis of 327 patients undergoing DCLC between January and December 2018 at Ysbyty Gwynedd (District General Hospital; YG) and Llandudno General Hospital (isolated unit; LLGH), North Wales, UK. Results The results showed that 100% of DCLCs in LLGH were successful; 71.4% of elective DCLCs were successful at YG. Increasing age ( p = 0.004), BMI ( p = 0.01), ASA Score ( p = 0.006), previous ERCP ( p = 0.05), imaging suggesting cholecystitis ( p = 0.003) and thick-walled gallbladder ( p = 0.04) were significantly associated with failed DCLC on univariate analysis. Factors retaining significance (OR, 95% CI) after multiple regression include BMI (1.82, 1.05–3.16; p = 0.034), imaging suggesting cholecystitis (4.42, 1.72–11.38; p = 0.002) and previous ERCP (5.25, 1.53–18.00; p = 0.008). Postoperative complications are comparable in BMI <35kg/m2 and 35–39.9kg/m2. Conclusions Current patient selection for isolated day unit is effective in ensuring safe discharge and could be further developed with greater consideration for patients with BMI 35–39.9kg/m2. As surgical services return, this helps identify patients suitable for laparoscopic cholecystectomy at isolated COVID-free day units.

Impact of Specialisation in the Practice of Rectal Cancer Surgery at a District General Hospital

Endoscopy ◽  
2004 ◽  
Vol 36 (10) ◽  
Author(s):  
AL Gidwani ◽  
RS Date ◽  
D Hughes ◽  
P Neilly ◽  
R Gilliland
Keyword(s):  
Rectal Cancer ◽  
General Hospital ◽  
District General Hospital ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery
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