ASGE guidelines result in cost-saving in the management of choledocholithiasis

Gaurav Singhvi, Rajiv Ampara, Joel Baum, Vivek Gumaste

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background The goal of this study was to determine whether utilization of the ASGE guidelines for the evaluation of bile duct stones (BDS) would result in fewer imaging studies and in turn lead to a lower healthcare expenditure. Methods This was a retrospective study set in an urban Teaching Hospital. Patients undergoing evaluation for BDS and who had their gallbladders in situ were included in the study. Data with regard to age, sex, clinical history, pain level, vital signs and laboratory studies as well as diagnostic tests performed were extracted from the hospital’s electronic medical record. The ASGE guidelines were applied retrospectively to each patient in the study group and the group was divided into two cohorts: one that followed the ASGE guidelines and one which did not. Patients in the two cohorts were further stratified into high-, intermediate-, and low-risk categories. Results Thirty-eight patients met the criteria and were included in the study. Of the 38 patients, 22 were managed as per the ASGE guidelines and 16 were not. Twenty-seven patients were categorized as high-risk (14 following the correct algorithm, 13 not) and 11 as intermediate-risk (8 following, 3 not). There were no low-risk patients. Twelve of the 27 patients in the high-risk group had stones (56%) while 6 of 11 (55%) had stones in the intermediate-risk group. Fourteen computed tomography scans and 12 magnetic resonance cholangiopancreatographies were deemed inappropriate resulting in unnecessary increased expenditure of $ 22,236. Conclusion The application of ASGE guidelines can minimize redundant investigations and effect cost saving but need to be refined to produce a better yield.

Original languageEnglish (US)
Pages (from-to)85-90
Number of pages6
JournalAnnals of Gastroenterology
Volume29
Issue number1
StatePublished - 2016
Externally publishedYes

Fingerprint

Choledocholithiasis
Guidelines
Costs and Cost Analysis
Health Expenditures
Bile Ducts
Magnetic Resonance Cholangiopancreatography
Vital Signs
Electronic Health Records
Urban Hospitals
Gallbladder
Routine Diagnostic Tests
Teaching Hospitals
Retrospective Studies
Tomography
Delivery of Health Care
Pain

Keywords

  • ASGE guidelines
  • Choledocholithiasis
  • ERCP

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Singhvi, G., Ampara, R., Baum, J., & Gumaste, V. (2016). ASGE guidelines result in cost-saving in the management of choledocholithiasis. Annals of Gastroenterology, 29(1), 85-90.

ASGE guidelines result in cost-saving in the management of choledocholithiasis. / Singhvi, Gaurav; Ampara, Rajiv; Baum, Joel; Gumaste, Vivek.

In: Annals of Gastroenterology, Vol. 29, No. 1, 2016, p. 85-90.

Research output: Contribution to journalArticle

Singhvi, G, Ampara, R, Baum, J & Gumaste, V 2016, 'ASGE guidelines result in cost-saving in the management of choledocholithiasis', Annals of Gastroenterology, vol. 29, no. 1, pp. 85-90.
Singhvi, Gaurav ; Ampara, Rajiv ; Baum, Joel ; Gumaste, Vivek. / ASGE guidelines result in cost-saving in the management of choledocholithiasis. In: Annals of Gastroenterology. 2016 ; Vol. 29, No. 1. pp. 85-90.
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