{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:37:51Z","timestamp":1776123471374,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001786","name":"University of Adelaide","doi-asserted-by":"publisher","award":["Divisional Scholarship"],"award-info":[{"award-number":["Divisional Scholarship"]}],"id":[{"id":"10.13039\/501100001786","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The acute surgical unit (ASU) model has been associated with improved outcomes for emergency general surgical patients. Few Australasian studies have investigated patients with cholecystitis and none from South Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study compared patients admitted to our institution with acute cholecystitis during the 2 years before (traditional period) and after (ASU period) introduction of an ASU on 1 August 2012. Primary outcomes were length of stay, rates of definitive surgery on index admission, time to definitive surgery and proportion of cases performed in\u2010hours. Secondary outcomes were time from emergency department referral to admission, time from radiologically confirmed diagnosis to theatre start, rates of conversion to open cholecystectomy, complications and cholelithiasis\u2010related representations while awaiting definitive procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 319 patients met the inclusion criteria; 172 and 147 pre\u2010 and post\u2010ASU introduction, respectively. Compared with the traditional period, ASU patients had shorter length of stay (3.80 versus 2.83 days, <jats:italic>P<\/jats:italic> &lt; 0.0001), higher rates of surgery on index admission (70.9% versus 95.3%, <jats:italic>P<\/jats:italic> &lt; 0.0001), shorter time to definitive surgery (28.1 versus 22.1 days, <jats:italic>P<\/jats:italic> &lt; 0.001), lower rates of conversion to open cholecystectomy (18.0% versus 7.1%, <jats:italic>P<\/jats:italic> = 0.007) and fewer complications (24.4% versus 6.1%, <jats:italic>P<\/jats:italic> &lt; 0.0001). Other outcomes were not significantly different.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Introduction of an ASU was associated with superior outcomes amongst patients admitted with acute cholecystitis. These findings extend the literature in support of the current model of care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14802","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T00:15:59Z","timestamp":1536711359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of an acute surgical unit on outcomes in acute cholecystitis"],"prefix":"10.1111","volume":"88","author":[{"given":"Zacharia T.","family":"Bazzi","sequence":"first","affiliation":[{"name":"Department of Surgery Lyell McEwin Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-2537","authenticated-orcid":false,"given":"Ned","family":"Kinnear","sequence":"additional","affiliation":[{"name":"Department of Surgery Lyell McEwin Hospital  Adelaide South Australia Australia"},{"name":"Department of Urology Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciara S.","family":"Bazzi","sequence":"additional","affiliation":[{"name":"Department of Surgery Modbury Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek","family":"Hennessey","sequence":"additional","affiliation":[{"name":"Department of Urology Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Henneberg","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Surgery Lyell McEwin Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(91)90591-Z"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1990.01410220029002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005440.pub2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.04.083"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1998.00708.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2008.04790.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb03908.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2010.05312.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2012.06248.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2010.05490.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12211"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12351"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.13403"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2009.04917_22.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2010.05331.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja11.11361"},{"key":"e_1_2_8_18_1","first-page":"A36","article-title":"The effectiveness of the surgical emergency team at Nambour Hospital in surgical assessment time and time to operation for acute appendicitis","volume":"80","author":"Geere SL","year":"2010","journal-title":"ANZ J. 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