Papers by Alexander Perez
Journal of Surgical Research, 2015
Background: Despite the established superiority of laparoscopic cholecystectomy for acute cholecy... more Background: Despite the established superiority of laparoscopic cholecystectomy for acute cholecystitis (AC), gangrenous cholecystitis (GC) is commonly treated with open cholecystectomy. This study aimed to characterize outcomes of GC in the modern era and between laparoscopic (LC) or open (OC) surgical approach. Materials and Methods: Patients with a diagnosis of GC were identified using the 2005-2011 NSQIP participant user file. Baseline patient and operative characteristics and 30-day outcomes were established for all patients. Patients were stratified by surgical approach (LC or OC), and groups were propensity matched with a nearest neighbor matching algorithm. Primary outcomes were 30-day mortality and any 30-day complication. A nonparsimonious multiple logistic regression model was used in the matched subset to adjust for patient comorbidities, demographics, and laboratory values. Results: N=141,970 cholecystectomies were identified with 7,017 having a diagnosis of GC. Overall 30-day mortality for the entire cohort was 0.8% (n=239) and overall 30-day complication rate was 8.0% (n=2,485). For GC patients the 30-day mortality was 1.2% (n=84) and overall complication rate was 10.8% (n=761). The multivariable logistic regression model demonstrated a significant decrease in overall (odds ratio [OR]= 0.46; p<0.001) complication rates for LC patients, but did not reveal a significant difference in 30-day mortality (OR=0.59; p=0.12).
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Papers by Alexander Perez