{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:27:35Z","timestamp":1761290855234},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2004,2,27]],"date-time":"2004-02-27T00:00:00Z","timestamp":1077840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,3,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The \u2018gold standard\u2019 treatment for acute cholecystitis and biliary colic requiring hospital admission is urgent laparoscopic cholecystectomy. This is not routinely available in all hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective audit of emergency admissions with acute cholecystitis or biliary colic from January to December 2000 led to the development and implementation of a specialist-led protocol for the urgent management of acute gallstone disease. A second audit was carried out covering the 6 months after implementation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One hundred and fifty-eight patients were admitted with acute cholecystitis or biliary colic in the first audit period and 110 in the second interval. The rate of cholecystectomy at index admission increased from 37\u00b73 to 67\u00b73 per cent, at a median of 3 days after admission, and the conversion rate to open surgery fell from 32 to 12 per cent. Median hospital stay fell from 9 to 5\u00b75 days, and the unplanned readmission rate decreased from 19\u00b70 to 3\u00b76 per cent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Urgent cholecystectomy for the management of acute gallstone disease is feasible and achievable in an acute services hospital with a specialist upper gastrointestinal team. It can lead to a reduced conversion rate, shorter hospital stay, fewer unplanned readmissions, an acceptable operating time and a low complication rate. The protocol is recommended for implementation in other hospitals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4458","type":"journal-article","created":{"date-parts":[[2004,3,23]],"date-time":"2004-03-23T13:33:23Z","timestamp":1080048803000},"page":"504-508","source":"Crossref","is-referenced-by-count":40,"title":["Implementation of a specialist-led service for the management of acute gallstone disease"],"prefix":"10.1093","volume":"91","author":[{"given":"S J","family":"Mercer","sequence":"first","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J S","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S K C","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A M","family":"Walters","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S A","family":"Sadek","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S S","family":"Somers","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2004,2,27]]},"reference":[{"key":"2021070911462617100_bib1","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/bjs.1800681102","article-title":"Early versus delayed cholecystectomy: the effect of a change in management","volume":"68","author":"Van der Linden","year":"1981","journal-title":"Br J Surg"},{"key":"2021070911462617100_bib2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1002\/bjs.1800700309","article-title":"Early or delayed cholecystectomy in acute cholecystitis? 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