Laparoscopic Acute Care Surgery in Liver Disease: A Regression Analysis of the Nationwide Inpatient Sample

Introduction: Patients with liver disease are being more frequently undergoing urgent and emergent surgery. There is sparse literature comparing outcomes based on modality of surgery (laparoscopic versus open) in this important cohort of patients. Our study examines surgical outcomes by liver disease status and surgical modality in acute care surgery setting. Methods: This is a retrospective cohort study of patients undergoing acute care abdominal surgery between 2006 and 2010 extracted from the National Inpatient Sample database. Surgical outcomes examined were in-hospital mortality, surgical, and medical complications, length of stay, and total hospital charges. Sequential multivariable generalized linear regression models were used to compare the outcomes across surgical modality and type of liver disease. Results: Unadjusted and adjusted analyses revealed that laparoscopic surgery was associated with marked reduction in mortality (92%) and surgical complications (86%) compared to open surgery, as well as a moderate yet significant reduction (60%) for medical complications, length of stay and total hospital charges. Patients with cirrhotic liver disease fared worse compared to those with non-cirrhotic and no liver disease, as expected. Conclusion: Laparoscopic surgery provides a feasible alternative for patients with liver disease undergoing acute care surgery. You can submit your Manuscripts at: https://symbiosisonlinepublishing.com/submitManuscript.php