A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy

Zacks, Steven; Sandler, Robert S.; Rutledge, Robert; Brown, Robert S.

doi:10.1111/j.1572-0241.2002.05466.x

Cited by 163 publications

(138 citation statements)

References 18 publications

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“…Consistent with results of other studies, 5,[28][29][30] open cholecystectomy was also predictive of mortality and postoperative complications. Given the data supporting the advantages of laparoscopic cholecystectomy, it is interesting that 216 (21.4%) of the patients in our study underwent open cholecystectomy; however, this finding is consistent with existing data that show rates of open cholecystectomy are higher in elderly patients.…”

Section: Original Research and Contributionssupporting

confidence: 81%

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Irojah¹,

Bell

Grim

et al. 2017

TPJ

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Context: Cholecystectomy is the most common general surgery procedure in patients older than age 65 years. By 2050, it is estimated that 2.0% of the population will be older than age 90 years.Objective: To assess the mortality of cholecystectomy in superelderly patients (≥ age 90 years).Design were open and 791 (78.6%) were laparoscopic. Mortality did not decrease significantly during the study period. The overall mortality was 5.5%, significantly less for the laparoscopic group (3.7% vs 12%, p < 0.001) and for the nonemergent group (4.5% vs 9.5%, p < 0.005). The median length of stay for open cholecystectomy was 9 days compared with 5 days for laparoscopic (p < 0.001); for nonemergent cholecystectomy it was 5 days compared with 7 days for emergent cholecystectomy (p < 0.001).Conclusion: The mortality after cholecystectomy in superelderly patients did not change significantly during the study period. The mortality and morbidity for laparoscopic and elective procedures were significantly lower than for open procedures and for emergent procedures, respectively.

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Section: Original Research and Contributionssupporting

confidence: 81%

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Irojah¹,

Bell

Grim

et al. 2017

TPJ

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“…Injury to the common bile duct is well known as a major contributor to cost and resource utilization, with immediate associated costs ranging from $13,612 to $30,000 and lifetime costs reported as high as $300,000 [21][22][23][24] . In addition, various patient, hospital, and surgeon factors -such as age, sex, presence of comorbidities, urgency of admission and surgery, length of stay (LOS), treatment in a regional or district hospital, hospital volume, and surgeon experience [25][26][27][28][29][30][31][32] -have been shown to affect cholecystectomy outcomes and associated overall resource use and costs.…”

Section: Case: the Cholecystectomy And Contributors To Resource Usementioning

confidence: 99%

Patient comorbidities increase postoperative resource utilization after laparoscopic and open cholecystectomy

Boehme

McKinley

Brunt³

et al. 2015

Surg Endosc

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“…A similar study noted that mortality risk was lower with LC than with the open procedure (Zacks, 2002). A population-based study performed by the French Society of Endoscopic and Operative Radiology Surgery (SFERO) indicated a conversion rate of 6.9%, a morbidity rate of 4.9% and a mortality rate of 0.2% (Collet, 1997), (Treatment studies 4).…”

Section: (Treatment Studies 1a)mentioning

confidence: 94%

“…Low quality: it very likely that future studies change our confidence in the estimate of effect, therefore our confidence is low. Table. 2001; Elder, 1996;Finan, 2006;Zacks, 2002;Collet, 1997;Ibrahim, 2006;Weber, 2003;Feldman, 1994;Perez Lara, 2006;Sungler, 2000;Daradkeh, 1999;Ji, 2005;Fernandes, 2000;Palanivelu, 2006;da Silveira, 2006;Gurusamy, 2006;Chandler, 2000;Kiviluoto, 1998;Glavic, 2001;Eldar, 1998;Lujan, 1995;Tan, 2006;Perez-Morales, 2005;Bagia, 2001;Schafer, 2003;Kwon, 2001;Woods, 1996).…”

Section: Discussionmentioning

confidence: 99%

“…Four SRs (ANDEM, 1994;Downs, 1996;Korolija, 2004;Keus, 2006a;Keus, 2006b), two RCTs (Mimica, 2000;Ros, 2001), three cohort studies (Devereaux, 2005;Elder, 1996;Finan, 2006), one CPG (Zacks, 2002), one cross-sectional study (Collet, 1997) and one case series (Ibrahim, 2006) were included. One SR concluded that laparoscopic techniques take longer than conventional techniques.…”

Section: Effectiveness Of Laparoscopic Cholecystectomymentioning

confidence: 99%

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Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

et al. 2010

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SUMMARY:The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008). Systematic reviews (SR), clinical practice guidelines (CPG), randomised clinical trials (RCT) and observational studies were included. Internal validity and overall quality of the evidence were assessed. The available evidence was classified according to the Oxford Centre for Evidence Based Medicine proposal. 87 studies were included in this review (12 SR, 23 RCT, 3 CPG, 13 cohort studies, 3 cross-sectional studies, 2 case and control studies and 31 case series). Compared with open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with shorter operating time, shorter hospital stay and better quality of life (high quality evidence). The use of antibiotic prophylaxis does not appear to reduce the infection rate in low-risk patients (high quality evidence). Although many techniques have been advocated to perform LC their effectiveness is as yet inconclusive (low-quality evidence). Two-stage surgery is the most appropriate strategy for high-risk patients with CBDL (high-quality evidence). Mortality is similar to open surgery, as the effectiveness is similar to that of endoscopic treatment (high-quality evidence). As a conclusion we can state that the evidence concerning the effectiveness of laparoscopic surgery for gallstones and CBDL is scarce and of low methodological quality and that better quality studies are warranted to assess these techniques more adequately.

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A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy

Cited by 163 publications

References 18 publications

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Patient comorbidities increase postoperative resource utilization after laparoscopic and open cholecystectomy

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

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