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Updated: Jul 14, 2025
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
Referral practices are associated with a delay in treatment of symptomatic cholelithiasis and cholecystitis
Lt Brittany Cook1, Maj Rathnayaka M K D Gunasingha1, Lt Sydney Dishman2
1Uniformed Services University of the Health Sciences, 4301 Jones Bridge Ave, Bethesda, MD, 20814, USA; Department of Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20814, USA.
Background:
The project was performed to determine if referrals to non-surgical providers after an initial presentation of symptomatic cholelithiasis are associated with a delay in surgical management.
Methods:
A single institution chart review of all adult patients who underwent a cholecystectomy from 2015 to 2019 was completed. Quantitative data was analyzed using independent t-tests.
Results:
Of 574 reviewed, 482 patients met criteria. Following initial presentation, 295 (61.2%) received a referral to surgery and 187 (38.8%) received follow up with a non-surgical provider. Those in the latter group had a significantly longer time from initial symptom presentation to surgical evaluation (65.7 days vs. 10.3 days, p < 0.001) and cholecystectomy (102.0 days vs 39.1 days, p < 0.001) when compared to the surgery referral group.
Conclusions:
This study demonstrated that cholecystectomy was significantly delayed for patients who had been referred to non-surgical providers after initial presentation, prolonging symptoms and increasing use of healthcare resources.
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