caa a22 4500 60549522X CHVBK 20210128100530.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00261-014-0265-z doi (NATIONALLICENCE)springer-10.1007/s00261-014-0265-z Image-guided percutaneous drainage vs. surgical repair of gastrointestinal anastomotic leaks: is there a difference in hospital course or hospitalization cost? [Elektronische Daten] [Lauren Burke, Mustafa Bashir, Carly Gardner, Arthur Parsee, Daniele Marin, David Vermess, Syamal Bhattacharya, Julie Thacker, Tracy Jaffe] Purpose: To identify differences in hospital course and hospitalization cost when comparing image-guided percutaneous drainage with surgical repair for gastrointestinal anastomotic leaks. Materials and methods: A retrospective IRB-approved search using key words "leak” and/or "anastomotic” was performed on all adult CT reports from 2002 to 2011. CT examinations were reviewed for evidence of a postoperative gastrointestinal leak and assigned a confidence score of 1-5 (1=no leak, 5=definite leak). Patients with an average confidence score <4 were excluded. Type of surgery, patient data, method of leak management, number of hospital admissions, length of hospital stay, discharge disposition, number of CT examinations, number of drains, and hospitalization costs were collected. Results: One hundred thirty-nine patients had radiographic evidence of a gastrointestinal anastomotic leak (esophageal, gastric, small bowel or colonic). Nine patients were excluded due to low confidence scores. Twenty-seven patients underwent surgical repair (Group A) and 103 were managed entirely with percutaneous image-guided drainage (Group B). There was no significant difference in patient demographics or number of hospital admissions. Patients in Group A had longer median hospital stays compared to Group B (48 vs. 32days, p=0.007). The median total hospitalization cost for Group A was more than twice that for Group B ($99,995 vs. $47,838, p=0.001). Differences in hospital disposition, number of CT examinations, number of drains, and time between original surgery and first CT examination were statistically significant. Conclusion: Gastrointestinal anastomotic leaks managed by percutaneous drainage are associated with lower hospital cost and shorter hospital stays compared with surgical management. Springer Science+Business Media New York, 2014 Anastomotic leak nationallicence Percutaneous drainage nationallicence Hospitalization cost nationallicence Length of stay nationallicence Burke Lauren Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Bashir Mustafa Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Gardner Carly Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Parsee Arthur Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Marin Daniele Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Vermess David Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Bhattacharya Syamal Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut Thacker Julie Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut Jaffe Tracy Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1279-1284 0942-8925 40:5<1279 2015 40 261 https://doi.org/10.1007/s00261-014-0265-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0265-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Burke Lauren Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Bashir Mustafa Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Gardner Carly Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Parsee Arthur Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Marin Daniele Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Vermess David Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Bhattacharya Syamal Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Thacker Julie Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Jaffe Tracy Department of Radiology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1279-1284 0942-8925 40:5<1279 2015 40 261