{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:36:54Z","timestamp":1760236614984,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T00:00:00Z","timestamp":1638748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Biliary tract diseases that are not adequately treated on index hospitalization are linked to worse outcomes, including high readmission rates. Delays in care for conditions such as choledocholithiasis, gallstone pancreatitis, and cholecystitis often occur due to multiple reasons, and this delay is under-appreciated as a source of morbidity and mortality. Our study is based on the latest Nationwide Readmissions Database review and evaluated the effects of postponing definitive management to a subsequent visit. The study shows a higher 30-day readmission rate in addition to increased mortality rate, intubation rate, vasopressor use in this patient population and significantly added financial burden.<\/jats:p>","DOI":"10.3390\/diseases9040089","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T03:21:05Z","timestamp":1638847265000},"page":"89","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cutting out Cholecystectomy on Index Hospitalization Leads to Increased Readmission Rates, Morbidity, Mortality and Cost"],"prefix":"10.3390","volume":"9","author":[{"given":"Karthik","family":"Gangu","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9932-9345","authenticated-orcid":false,"given":"Aniesh","family":"Bobba","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, John H Stroger Hospital of Cook County, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harleen Kaur","family":"Chela","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Basar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rush Medical Collage, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6796-9359","authenticated-orcid":false,"given":"Veysel","family":"Tahan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-1704","authenticated-orcid":false,"given":"Ebubekir","family":"Daglilar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.surge.2015.10.002","article-title":"Endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis","volume":"14","author":"Schepers","year":"2016","journal-title":"Surgeon"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S1665-2681(19)32155-6","article-title":"Microlithiasis: An important cause of \u201cidiopathic\u201d acute pancreatitis?","volume":"2","author":"Venneman","year":"2003","journal-title":"Ann. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1053\/j.gastro.2013.01.068","article-title":"The Epidemiology of Pancreatitis and Pancreatic Cancer","volume":"144","author":"Yadav","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1097\/SLA.0b013e3182507646","article-title":"Timing of Cholecystectomy after Mild Biliary Pancreatitis","volume":"255","author":"Besselink","year":"2012","journal-title":"Ann. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1089\/lap.2017.0527","article-title":"Timing of Laparoscopic Cholecystectomy after Mild Biliary Pancreatitis: A Systematic Review and Meta-Analysis","volume":"28","author":"Yang","year":"2018","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1002\/bjs.11221","article-title":"Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis","volume":"106","author":"Moody","year":"2019","journal-title":"BJS"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.asjsur.2016.07.010","article-title":"Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study","volume":"41","author":"Jee","year":"2018","journal-title":"Asian J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S0140-6736(15)00274-3","article-title":"Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): A multicentre randomised controlled trial","volume":"386","author":"Bouwense","year":"2015","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/SLA.0b013e3181c38f1f","article-title":"Early Cholecystectomy Safely Decreases Hospital Stay in Patients with Mild Gallstone Pancreatitis","volume":"251","author":"Aboulian","year":"2010","journal-title":"Ann. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.hpb.2019.05.013","article-title":"Early laparoscopic cholecystectomy reduces hospital stay in mild gallstone pancreatitis. A randomized controlled trial","volume":"22","author":"Riquelme","year":"2020","journal-title":"HPB"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1001\/archsurg.143.6.533","article-title":"Early Laparoscopic Cholecystectomy Is the Preferred Management of Acute Cholecystitis","volume":"143","author":"Casillas","year":"2008","journal-title":"Arch. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/SLA.0b013e3182a1599b","article-title":"Acute Cholecystitis","volume":"258","author":"Gutt","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5528","DOI":"10.3748\/wjg.v12.i34.5528","article-title":"Timing of laparoscopic cholecystectomy for acute cholecystitis: A prospective non randomized study","volume":"12","author":"Tzovaras","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1007\/PL00012283","article-title":"Laparoscopic cholecystectomy for acute cholecystitis: Prospective trial","volume":"21","author":"Eldar","year":"1997","journal-title":"World J. Surg."},{"key":"ref_15","first-page":"11","article-title":"Early or delayed laparoscopic cholecystectomy in acute cholecystitis? Conclusions of a controlled trial","volume":"56","author":"Rojo","year":"2009","journal-title":"Hepatogastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"328","DOI":"10.4149\/BLL_2016_065","article-title":"Early versus delayed laparoscopic cholecystectomy in treatment of acute cholecystitis","volume":"117","author":"Rajcok","year":"2016","journal-title":"Bratisl. Med. J."},{"key":"ref_17","first-page":"400","article-title":"Laparoscopic cholecystectomy in the treatment of acute cholecystitis. Prospective non-randomized study","volume":"24","author":"Pessaux","year":"2000","journal-title":"Gastroent\u00e9rol. Clin. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1159\/000085300","article-title":"Urgent Laparoscopic Cholecystectomy Is the Best Management for Biliary Colic","volume":"22","author":"Salman","year":"2005","journal-title":"Dig. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1053\/j.gastro.2010.02.052","article-title":"Early Laparoscopic Cholecystectomy Improves Outcomes after Endoscopic Sphincterotomy for Choledochocystolithiasis","volume":"138","author":"Reinders","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1007\/s00534-009-0169-4","article-title":"The timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreaticography in cholelithiasis coexisting with choledocholithiasis","volume":"16","author":"Salman","year":"2009","journal-title":"J. Hepato-Biliary-Pancreat. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.pan.2013.07.063","article-title":"IAP\/APA evidence-based guidelines for the management of acute pancreatitis","volume":"13","author":"Deviere","year":"2013","journal-title":"Pancreatology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1053\/j.gastro.2007.03.066","article-title":"AGA Institute Medical Position Statement on Acute Pancreatitis","volume":"132","author":"Baillie","year":"2007","journal-title":"Gastroenterology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s00464-005-0235-1","article-title":"National analysis of in-hospital resource utilization in choledocholithiasis management using propensity scores","volume":"20","author":"Poulose","year":"2005","journal-title":"Surg. Endosc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1001\/jamasurg.2016.2059","article-title":"Nationwide Assessment of Trends in Choledocholithiasis Management in the United States From 1998 to 2013","volume":"151","author":"Wandling","year":"2016","journal-title":"JAMA Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e181167","DOI":"10.1001\/jamasurg.2018.1167","article-title":"Comparison of Efficacy and Safety of 4 Combinations of Laparoscopic and Intraoperative Techniques for Management of Gallstone Disease With Biliary Duct Calculi","volume":"153","author":"Ricci","year":"2018","journal-title":"JAMA Surg."},{"key":"ref_26","unstructured":"(2021, December 02). Available online: https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nrd\/Introduction_NRD_2010-2018.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/ans.13981","article-title":"Acute cholangitis: Current concepts","volume":"87","author":"Wah","year":"2017","journal-title":"ANZ J. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1220.e1","DOI":"10.1016\/j.amjmed.2017.05.025","article-title":"Patterns of Readmissions for Three Common Conditions Among Younger US Adults","volume":"130","author":"Sukul","year":"2017","journal-title":"Am. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e2032669","DOI":"10.1001\/jamanetworkopen.2020.32669","article-title":"Comparison of Utilization, Costs, and Quality of Medicaid vs Subsidized Private Health Insurance for Low-Income Adults","volume":"4","author":"Allen","year":"2021","journal-title":"JAMA Netw. Open"}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/9\/4\/89\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:40:09Z","timestamp":1760168409000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/9\/4\/89"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,6]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["diseases9040089"],"URL":"https:\/\/doi.org\/10.3390\/diseases9040089","relation":{},"ISSN":["2079-9721"],"issn-type":[{"type":"electronic","value":"2079-9721"}],"subject":[],"published":{"date-parts":[[2021,12,6]]}}}