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.

Original Release Date: November 2018
Review Date: September 2023

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 ABS MOC II
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 General certificate of attendance
Course opens: 
11/01/2020
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., speaker and conference director for this educational activity, has indicated that he is a consultant with Teleflex, Inc., and Trans Enterex, Inc. and has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

All of the relevant financial relationships listed for this individual has been mitigated.

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

*Ineligible companies -- Companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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.

image

American Board of Surgery - Maintenance of Certification (MOC) - Accredited CME - General Surgery

Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Your participation information will be shared with specialty boards through the ACCME's PARS reporting system. Successful completion of a course examination is required. Submissions are recorded in approximately 48 hours. You will receive an email when your credits have been processed.

Available Credit

  • 0.50 ABS MOC II
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 General certificate of attendance
Please login or register for a Baptist Health CME account to take this course.

Required Hardware/Software

PC/Mac Users
PC/Mac Users

This site is supported on the most recent stable releases of the following browsers:

Click Here to Download Google Chrome
Google Chrome
Microsoft Edge
Microsoft Edge
Safari
Safari
Moxilla Firefox
Mozilla Firefox
Internet Explorer

Attention: Internet Explorer Users
This site offers limited support for Internet Explorer 11 (IE11). When using IE11, you will be prompted to download course videos instead of viewing them in the browser. After the course video downloads, the recordings will play.

Mobile Users
Mobile Users

This site is supported on the following mobile devices:

  • Apple iOS mobile devices running iOS 10 or later
  • Android mobile devices running Android 4.4 or later, with the latest release of Google Chrome or Mozilla Firefox
Technical Support
Technical Support

If you are experiencing technical difficulties or have received an error message, please send an email to CME@baptisthealth.net and include a print screen of the error message, your browser name and version, username and URL where the error occurred. You can expect a response within 48 hours.