Evidence-based Clinical Care: Laparoscopic Cholecystectomy

Key practice changes by emergency department physicians, hospitalists and surgeons will reduce unnecessary imaging, expedite surgeon consultation and reduce antibiotic resistance. Learn more about the future workflow for laparoscopic cholecystectomy with Dr. Juan Carlos Verdeja.

Note to Physicians: Be sure to bookmark this course to access all protocols, pathways, policies and procedures at your convenience via your CME Portal account. All power plans are available in Cerner. All EBCC deliverables will be available on the EBCC website.

Target Audience

Emergency Department Physicians, Hospitalists, Infectious Disease Physicians, Surgeons and Primary Care Physicians.

Learning Objectives

  • Explain standardization efforts and the necessity for the creation of a clinical pathway based on current evidence-based best practices by utilization of the laparoscopic cholecystectomy power plans.
  • Describe the rationale for the use of ultrasound as first-choice imaging, instead of computed tomography (CT) scan or cholescintigram (PIPIDA scan) and allowing for shared decision making with the consulted surgeon for further diagnostics.
  • Apply key practice changes with regard to patients’ preoperative needs, medications, education, discharge planning and follow-up.
  • Classify patients as high- and low-risk groups as defined in the power plan, and implement the corresponding antibiotic recommendations based on antibiotic stewardship guidelines.
  • Utilize early ambulation and diet advancement initiated in PACU to transition the patient through the continuum of care. 
  • Manage the patient throughout the laparoscopic cholecystectomy pathway by implementing intravenous therapy (IV) to oral (PO) antibiotic de-escalation when appropriate.
Additional information
Bibliography: 

Cost variation in a laparoscopic cholecystectomy and the association with outcomes across a single health system: implications for standardization and improved resource utilization. HPB (Oxford). 2015 Dec;17(12): 1113-1118

Gutt, C. N., Encke, J., Harnoss, J. C., Koninger, J., Weigand, K., Kipmuller, K., . . . Buchler, M. W. (2013). Faculty of 1000 Evaluation for Acute Cholecystitis: Early Versus Delayed Cholecystectomy, A Multicenter Randomized Trial (ACDC Study, NCT00447304). Annals of  Surgery, 258(3), 385-393. doi:10.3410/f.718105549.793485718

Resources: 

How to save power plans (EBCC order sets) to your favorites on CERNER? Click here to access video tutorial.​

Course summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 General certificate of attendance
Course opens: 
11/01/2018
Course expires: 
10/31/2023

Juan Carlos Verdeja, M.D.
General and Minimally Invasive Surgeon
Baptist Health South Florida
Associate Professor in the Department of Surgery
Director of Laparoscopy and Minimally Invasive Surgery
FIU Herbert Wertheim College of Medicine
Miami, Florida

Juan Carlos Verdeja, M.D., has indicated that he is a consultant with Teleflex, Inc., and Trans Enterex, Inc. Dr. Verdeja will not include off-label or unapproved product usage in his presentation or discussion.

Non-faculty contributors and others involved in the planning, development and editing/review of the content have no relevant financial relationships to disclose.

Disclosure Policy and Disclaimer


Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
             
Baptist Health South Florida designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 General certificate of attendance
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