Cholecystectomy guidelines in the UK recommend surgeons perform more than 40 procedures per year. This retrospective study aims to assess variation in outcomes in patients operated by high and low volume surgeons as well as those that work in an upper GI specialist unit.

 

Methods

Elective cholecystectomies performed between 2003 and 2012 were included. The data was analysed by volume with surgeons performing over 40 per year or fewer, and by specialism with surgeons in the upper GI directorate compared to others. Results were analysed by the Fishers Exact test and Odds Ratios for categorical variables and independent t-test for continuous variables.
 
Results
During the study period, 5350 patients underwent cholecystectomy. In the low volume group the rate of conversion to an open procedure was significantly higher 4.4 vs. 1.2% OR 3.82 (2.61-5.59), the day case rate was lower 25.2% vs. 46.3% OR 2.56 (2.27-2.89), and the length of stay was longer 1.45 days vs. 1.02 days (p< 0.0001). These findings were similarly demonstrated in the non upper GI specialist group; conversion to open 3.8% vs. 0.6% OR 6.57 (3.76-11.48), day case rate 31.4% vs. 47.2% 1.95 (1.75-2.18), length of stay 1.32 days vs. 1.01 days (P< 0.0001). In addition, a higher reoperation within 30 days rate 4.8% vs. 2.6%, 1.91 (1.41-2.59) was reported when compared to upper GI specialists.
 
Conslusions
This data supports the national guidelines for surgeon volume and cholecystectomy, and demonstrates an improvement in outcomes in patients operated by surgeons working within a specialist unit.
 
Publication date: 2019/3/1 - Journal: Ambulatory Surgery
Authors: S Zaman, E Rawstorne, M Daskalakis, R Nijjar, P Super, M Richardson, R Singhal
 
 
 
 
 
 
 

Obesity has a negative effect on quality of life (QoL). Bariatric surgery results in significant weight loss with improvement of QoL. Very few studies have evaluated QoL after sleeve gastrectomy (SG), especially with a long-term follow-up.

 

Methods

Morbidly obese patients admitted for laparoscopic SG over a 30-month period were prospectively studied. QoL was assessed using the Greek version of the MAII questionnaire and a visual analog scale preoperatively and at 6, 12, 24, and 60 months postoperatively. Anthropometric data and obesity-related co-morbidities were recorded.
 
Results
A total of 95 patients with mean age of 37.4 ± 9.2 years and body mass index of 48.3 ± 7.1 kg/m2 completed the 5-year follow-up. Percentage excess body mass index loss was 51.7 ± 14.2, 64.8 ± 16.9, 67.4 ± 17.7, and 55.8 ± 25.5 at 6, 12, 24, and 60 months, respectively. All obesity-related co-morbidities improved significantly. MAII score increased from −.38 ± 1.3 preoperatively to 1.77 ± .8, 2.08 ± 0.8, 2.12 ± .7, and 1.67 ± 1.1 at the above time points, respectively (trend P < .001), and visual analog scale increased from 3.05 ± 1.6 to 9.11 ± 1.0, 9.2 ± 1.1, 9.03 ± 1.3, and 7.85 ± 2.4 (P < .001). Overall QoL scores at 6 and 24 months (P < .001), as well as patients' female sex, correlated significantly with higher QoL at the end of the study.
 
Conslusions
Laparoscopic SG is an effective bariatric operation, resulting in significant weight loss and improvements in QoL. Female sex and higher MAII score at 6 and 24 months predict better long-term QoL outcome.
 
Publication date: 2018/11/1 - Journal: Surgery for Obesity and Related Diseases - Publisher: Elsevier
Authors: Vasileios Charalampakis, Charalampos Seretis, Markos Daskalakis, Christos Fokoloros, Ahmed Karim, John Melissas
 
 
 
 
 
 
 

Publication date: 2019/9/1 - Conference: BRITISH JOURNAL OF SURGERY - Publisher: WILEY

Authors: Emma Watts, Rackesh Patel, Rishi Singhal, Raj Nijjar, Martin Richardson, Markos Daskalakis
 
 
 
 
 
 
 

Publication date: 2018/8/1 - Conference: BRITISH JOURNAL OF SURGERY - Publisher: WILEY

Authors: S Bhanderi, Q Ain, M Daskalakis, M Richardson, R Singhal
 
 
 

 
 

Publication date: 2018/7/1 - Conference: BRITISH JOURNAL OF SURGERY - Publisher: WILEY

Authors: Mohamed Sahloul, Markos Daskalakis, Rishi Singhal
 
 
 
 
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