{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T14:04:37Z","timestamp":1769004277282,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence suggests index cholecystectomy (IC) in patients with acute cholecystitis is safe, has decreased hospital stay and is cheaper than delayed cholecystectomy (DC). Costs of cholecystectomy have not previously been investigated in New Zealand. The aim of this study was to compare cost of IC with DC for patients with acute cholecystitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of adults admitted to Northland hospitals with acute cholecystitis between 1 January 2015 and 31 December 2019 who underwent subsequent cholecystectomy, was performed. Actual patient\u2010level costs were utilized for cost comparison between IC and DC. Factors associated with increased costs were assessed using multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and eleven patients were included in the study; 72 (34%) underwent IC and 139 (65%) DC. There was no significant difference in total cost for IC ($12\u2009767) versus DC ($12\u2009029) (<jats:italic>p\u2009=<\/jats:italic>\u00a00.192); this persisted on multivariate analysis. Patients having IC had more severe cholecystitis, and 90\u2010day representation rate following DC was 35%. Costs were increased by severity of cholecystitis, age, American Society of Anesthesiology score (ASA) and travel distance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed there is no significant difference in cost between IC and DC for patients with acute cholecystitis in Northland, New Zealand. Severity, increasing age, ASA and travel distance were drivers of costs. To recognize the cost benefits of IC, it is likely that increased rates of IC are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17829","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T13:48:24Z","timestamp":1654523304000},"page":"1675-1680","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost analysis of index versus delayed cholecystectomy for acute cholecystitis in a New Zealand Provincial Centre"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8023-5058","authenticated-orcid":false,"given":"Gajan","family":"Srikumar","sequence":"first","affiliation":[{"name":"Department of General Surgery Whangarei Hospital, Northland District Health Board  Whangarei New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0842-5922","authenticated-orcid":false,"given":"Matthew James","family":"McGuinness","sequence":"additional","affiliation":[{"name":"Department of General Surgery Whangarei Hospital, Northland District Health Board  Whangarei New Zealand"},{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6466-5472","authenticated-orcid":false,"given":"Niki","family":"Kau","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9221-6674","authenticated-orcid":false,"given":"Cameron","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Harmston","sequence":"additional","affiliation":[{"name":"Department of General Surgery Whangarei Hospital, Northland District Health Board  Whangarei New Zealand"},{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1252","article-title":"Surgical timing in biliary tract disease","volume":"96","author":"Bruce TA","year":"1967","journal-title":"Can. 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