{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:39:58Z","timestamp":1777448398754,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Laparoscopic cholecystectomy (LC), one of the most common surgical procedures performed in the U.S., offers a window into the effects of the COVID-19 pandemic on routine surgical care. The purpose of our study was to analyze the effects of the COVID-19 pandemic at a Level-1 trauma center on the performance rate of non-elective LC over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review from July 2019 to December 2020 identified all non-elective LC cases performed at a level-1 trauma center. Patients were categorized into 4 temporal phases along the course of the pandemic based on statewide incidence data on COVID-19: pre-pandemic, peak 1, recovery, and peak 2. We compared the phases based on demographic information and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 176 patients were reviewed. The performance rate in cases\/day varied as follows: pre-pandemic .61, 1st peak .34, recovery .44, and 2nd peak .53. The complication rate was highest in the 2nd peak (16%) ( P &lt; .05). Compared to the pre-pandemic period, the intra-pandemic period had a higher incidence of complicated gallbladder disease ( P &lt; .05). In the non-elderly subgroup, complicated gallbladder disease was significantly more prevalent in the intra-pandemic period compared to the pre-pandemic period (25% vs 10%, P &lt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data suggests a learning curve throughout the course of the pandemic, reflecting a stepwise increase in the performance rate of LC. The higher incidence of complicated gallbladder disease in the intra-pandemic period may imply patient hesitancy to seek routine surgical care, especially among younger patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348221121552","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T21:19:13Z","timestamp":1662585553000},"page":"4632-4639","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Laparoscopic Cholecystectomy in the Time of Coronavirus: A Level-1 Trauma Center\u2019s Experience"],"prefix":"10.1177","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2617-4936","authenticated-orcid":false,"given":"Ryan B.","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Severance","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha N.","family":"Olafson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-1075","authenticated-orcid":false,"given":"Candace L.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afshin","family":"Parsikia","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexi R.","family":"Bloom","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Moran","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pak","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA"},{"name":"Department of Surgery, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"bibr1-00031348221121552","doi-asserted-by":"publisher","DOI":"10.1007\/s10353-021-00692-1"},{"key":"bibr2-00031348221121552","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08477-z"},{"key":"bibr3-00031348221121552","doi-asserted-by":"publisher","DOI":"10.1016\/j.ciresp.2020.07.001"},{"issue":"2","key":"bibr4-00031348221121552","first-page":"135","volume":"9","author":"Vakili S","year":"2021","journal-title":"J Heal Sci Surveill 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