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Experience with biliary audit.

C Battersby1, A Askew

  • 1Division of Surgery, Royal Brisbane Hospital, Queensland, Australia.

The Australian and New Zealand Journal of Surgery
|August 1, 1991
PubMed
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This surgical audit of gallstone disease found no mortality over 3.5 years. The study informed changes in antibiotic policy and highlighted the importance of surgical audits for performance monitoring.

Area of Science:

  • Surgery
  • Gastroenterology
  • Medical Auditing

Background:

  • Gallstone disease necessitates surgical intervention.
  • Surgical audits are crucial for evaluating and improving patient care outcomes.
  • Monitoring surgical performance is essential in modern medical practice.

Purpose of the Study:

  • To audit surgical outcomes for gallstone disease.
  • To assess key performance indicators including mortality, duct exploration, infection, and re-operation rates.
  • To evaluate the impact of surgical practice on patient outcomes and inform policy changes.

Main Methods:

  • Retrospective audit of 346 patients undergoing surgery for gallstones over 3.5 years.
  • Analysis of surgical outcomes: mortality, common bile duct exploration rate, infection rate, and re-operation rate for retained stones.

Related Experiment Videos

  • Bile culture from 278 gallbladders to identify common pathogens.

    • Main Results:

    • Zero mortality observed in the audited patient cohort.
    • Common bile duct exploration rate was 17%.
    • Infection rate was 8.6%, and re-operation rate for retained bile duct stones was 1.6%.
    • Bile cultures revealed positive results in 23.7% of cases, with coliforms and streptococci being the most frequent organisms.
    • Findings led to a revision of the hospital's antibiotic policy.

    Conclusions:

    • Surgical management of gallstones can achieve excellent outcomes with no mortality.
    • Surgical audits are vital for performance monitoring and can drive evidence-based improvements in clinical practice, such as antibiotic stewardship.
    • Standardized data collection through simple, accurate forms is key for effective surgical audits.