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Updated: Jun 18, 2025
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Barriers to elective cholecystectomy following emergency department discharge for symptomatic cholelithiasis
Joshua Gazzetta1, Rita Orjionwe1, Alyssa Fesmire1
1Saint Luke's Hospital of Kansas City, University of Missouri Kansas City School of Medicine, 4320 Wornall Road, Suite 530, Kansas City, MO, 64113, United States.
Background:
Patients with symptomatic cholelithiasis are often discharged from the Emergency Department (ED) and asked to follow-up for elective cholecystectomy. We aimed to identify the social determinants of health (SDOH) that serve as barriers to elective cholecystectomy and to assess the associated impact on patient outcomes.
Methods:
We conducted a multi-institutional, retrospective cohort study of patients discharged from the ED with symptomatic cholelithiasis. Univariable logistic regression was used to assess for variables associated with re-presenting to the ED rather than for elective cholecystectomy. P values < 0.05 identified significance.
Results:
Univariate analysis identified lack of a primary care physician, Black race, self-pay, language other than English as the primary language, and unemployed status to be independently associated with re-presentation to the ED for biliary disease.
Conclusions:
Socially disadvantaged populations would benefit from surgery at the time of presentation to the ED versus being sent home for elective follow-up.
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