Appropriateness variation in cholecystectomy

Quintana, José M.; Cabriada, José Luis; Tejada, I. López de; Perdigo, Luis; Aróstegui, Inmaculada; Bilbao, Amaia; Garay, Idoia

doi:10.1093/eurpub/14.3.252

The European Journal of Public Health

2004

DOI: 10.1093/eurpub/14.3.252

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Appropriateness variation in cholecystectomy

José M. Quintana

José Luis Cabriada²,

I. López de Tejada³

et al.

Abstract: This study identified a low percentage of inappropriately performed cholecystectomies in our area. Even so, appropriateness differences among hospitals were found.

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Cited by 6 publications

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“…There are no international guidelines that indicate which patient to offer a cholecystectomy or conservative treatment. Therefore, the indication to perform a cholecystectomy lies within the surgeons’ preference leading to variations in practice and consequently unnecessary cholecystectomies [8–11]. Annually, approximately 800,000 cholecystectomies are performed in the USA alone and the costs are estimated to be $6 billion [12].…”

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confidence: 99%

Cost-effectiveness of a new strategy to identify uncomplicated gallstone disease patients that will benefit from a cholecystectomy

et al. 2016

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BackgroundThe aim of this study was to determine the cost-effectiveness of a new strategy for the preoperative detection of patients that will likely benefit from a cholecystectomy, using simple criteria that can be applied by surgeons. Criteria for a cholecystectomy indication are: (1) having episodic pain; (2) onset of pain 1 year or less before the outpatient clinic visit.MethodsThe cost-effectiveness of the new strategy was evaluated against current practice using a decision analytic model. The incremental cost-effectiveness of applying criteria for a cholecystectomy for a patient with abdominal pain and gallstones was compared to applying no criteria. The incremental cost-effectiveness ratio (ICER) was expressed as extra costs to be invested to gain one more patient with absence of pain. Scenarios were analyzed to assess the influence of applying different criteria.ResultsThe new strategy of applying one out of two criteria resulted in a 4 % higher mean proportion of patients with absence of pain compared to current practice with similar costs. The 95 % upper limit of the ICER was €4114 ($4633) per extra patient with relief of upper abdominal pain. Application of two out of two criteria resulted in a 3 % lower mean proportion of patients with absence of pain with lower costs.ConclusionThe new strategy of using one out of two strict selection criteria may be an effective but also a cost-effective method to reduce the proportion of patients with pain after cholecystectomy.

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confidence: 99%

Cost-effectiveness of a new strategy to identify uncomplicated gallstone disease patients that will benefit from a cholecystectomy

et al. 2016

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What happens to biliary colic patients in New York State? 10-year follow-up from emergency department visits

et al. 2017

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Evaluation of the Gastrointestinal Quality of Life Index as a System to Prioritize Patients on the Waiting List for Laparoscopic Cholecystectomy

Roig¹,

Delgado²,

Espinosa³

et al. 2013

Cirugía Española (English Edition)

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Appropriateness variation in cholecystectomy

Abstract: This study identified a low percentage of inappropriately performed cholecystectomies in our area. Even so, appropriateness differences among hospitals were found.

Cited by 6 publications

References 22 publications

Cost-effectiveness of a new strategy to identify uncomplicated gallstone disease patients that will benefit from a cholecystectomy

Cost-effectiveness of a new strategy to identify uncomplicated gallstone disease patients that will benefit from a cholecystectomy

What happens to biliary colic patients in New York State? 10-year follow-up from emergency department visits

Evaluation of the Gastrointestinal Quality of Life Index as a System to Prioritize Patients on the Waiting List for Laparoscopic Cholecystectomy

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