Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database

Murata, Atsuhiko; Okamoto, Kohji; Muramatsu, Keiji; Kubo, Toshikazu; Fujino, Yoshihisa; Matsuda, Shinya

doi:10.1016/j.jss.2013.09.015

Cited by 20 publications

(69 citation statements)

References 32 publications

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“…[11][12][13] To address these issues, the Ministry of Health, Labour, and Welfare and its affiliated research institute have begun investigating whether the Japanese case-mix classification system, namely, the DPC, can be used to standardize medical profiling and payment. [11][12][13] Japanese case-mix projects based on the DPC system were introduced to 82 academic hospitals (the National Cancer Center, the National Cardiovascular Center, and 80 university hospitals) in 2003. [11][12][13][14][15] Reimbursement from health insurance using the DPC system is common practice in Japan.…”

Section: Methodsmentioning

confidence: 99%

“…[11][12][13] Japanese case-mix projects based on the DPC system were introduced to 82 academic hospitals (the National Cancer Center, the National Cardiovascular Center, and 80 university hospitals) in 2003. [11][12][13][14][15] Reimbursement from health insurance using the DPC system is common practice in Japan. According to the administrative database of the DPC system, the number of acute-care hospitals has increased.…”

Section: Methodsmentioning

confidence: 99%

“…Enormous amounts of inpatient data are collected annually, covering approximately 90% of the total acute-care inpatient hospitalizations. [11][12][13][14][15] This system also collects important data during hospitalization in addition to the characteristics of the unique reimbursement system. Each patient's financial data, claim information, and discharge summary (including the principal diagnosis, complications, and comorbidities during hospitalization) are thoroughly recorded in the administrative database of the DPC system.…”

Section: Methodsmentioning

confidence: 99%

“…These hospitals are dispersed throughout Japan and play leading roles in providing acute-care medicine, advancing medical research, and educating students and medical residents. [11][12][13][14][15] For the present analysis, 3 study periods were established according to the following fiscal years: 2010 (n ¼ 3308), 2011 (n ¼ 5403), and 2012 (n ¼ 5613).…”

Section: Study Settingmentioning

confidence: 99%

“…The DPC-participating hospitals send all the anonymized data to the DPC research group, which in turn sends it to the server in our department. [11][12][13][14][15] The use of DPC data was permitted by all institutions and hospitals that provided detailed data. The research protocol of the study was approved by the ethics committee of medical care and research of the University of Occupational and Environmental Health, Kitakyushu, Japan.…”

Section: Study Settingmentioning

confidence: 99%

See 4 more Smart Citations

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

Murata

Okamoto

Mayumi

et al. 2015

Clin Appl Thromb Hemost

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This study investigated the time trends and hospital factors affecting the use of drugs for infectious disease-associated disseminated intravascular coagulation (DIC) based on a national administrative database. A total of 14 324 patients with infectious disease-associated DIC were referred to 1041 hospitals from 2010 to 2012 in Japan. Patients' data were collected from the administrative database to determine time trends and hospital factors affecting the use of drugs for DIC. Three study periods were established, namely, the fiscal years 2010 (n ¼ 3308), 2011 (n ¼ 5403), and 2012 (n ¼ 5613). The use of antithrombin, heparin, protease inhibitors, and recombinant human soluble thrombomodulin (rhs-TM) for DIC was evaluated. The frequency of use of antithrombin, heparin, and protease inhibitors decreased while that of rhs-TM significantly increased from 2010 to 2012 in Japan (25.1% in 2010, 43.1% in 2011, and 56.8% in 2012; P < .001, respectively). Logistic regression showed that the study period was associated with the use of rhs-TM in patients with DIC. The odds ratio (OR) for 2011 was 2.34 (95% confidence interval [CI], 2.12-2.58; P < .001) whereas that for 2012 was 4.34 (95% CI, 3.94-4.79; P < .001). A large hospital size was the most significant factor associated with the use of rhs-TM in patients with DIC (OR, 3.14; 95% CI, 2.68-3.66; P < .001). The use of rhs-TM has dramatically increased. A large hospital size was significantly associated with the increased use of rhs-TM in patients with DIC from 2010 to 2012 in Japan.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

See 3 more Smart Citations

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

Murata

Okamoto

Mayumi

et al. 2015

Clin Appl Thromb Hemost

Self Cite

View full text Add to dashboard Cite

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Analysis of gallstone disease after gastric cancer surgery

et al. 2017

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Background The incidence rate of newly developed gallstone disease after gastrectomy for gastric cancer is thought to be higher than that in the general population. However, the presentation and management of these gallstones remain under debate, and the role of prophylactic cholecystectomy remains questionable. Methods Data on adult patients who were diagnosed with gastric cancer and received gastrectomy between 2000 and 2011 were extracted from the Taiwan National Health Insurance Research Database. A patient was excluded if he or she had gallstone disease or received cholecystectomy before the index date. The incidence of newly developed gallstone disease and its subsequent management were recorded. Data were analyzed to evaluate the factors associated with gallstone development and treatment options. Results A total of 17,325 gastric cancer patients who underwent gastrectomy were eligible for analysis. During the follow-up period (mean 4.1 years; median, 2.9 years), 1280 (7.4%) patients developed gallstone disease and 560 (3.2%) patients subsequently underwent cholecystectomy. The in-hospital mortality for cholecystectomy was 1.8% (10/560). Development of gallstone disease was associated with older age, total gastrectomy, duodenal exclusion, diabetes, cirrhosis, and more comorbidities. Factors associated with the use of cholecystectomy to treat gallstone disease included younger age, fewer comorbidities, medical center admission, and presentation as cholecystitis. Conclusions Although few patients required further gallbladder removal after gastrectomy for gastric malignancy, the increased mortality rate for subsequent cholecystectomy was worth noting. The decision to undergo prophylactic cholecystectomy might be individualized based upon patient characteristics and the surgeon's discretion.

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The Cholegas trial: long-term results of prophylactic cholecystectomy during gastrectomy for cancer—a randomized-controlled trial

et al. 2018

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Background The incidence of cholelithiasis has been shown to be higher for patients after gastrectomy than for the general population, due to vagal branch damage and gastrointestinal reconstruction. The aim of this trial was to evaluate the need for routine concomitant prophylactic cholecystectomy (PC) during gastrectomy for cancer. Methods A multicenter, randomized, controlled trial was conducted between November 2008 and March 2017. Of the total 130 included patients, 65 underwent PC and 65 underwent standard gastric surgery only for curable cancers. The primary endpoint was cholelithiasis-free survival after gastrectomy for gastric adenocarcinoma. Cholelithiasis was detected by ultrasound exam.Results After a median follow-up of 62 months, eight patients (12.3%) in the control group developed biliary abnormalities (four cases of gallbladder calculi and four cases of biliary sludge), with only three (4.6%) being clinically relevant (two cholecystectomies needed, one acute pancreatitis). One patient in the PC group had asymptomatic biliary dilatation during sonography after surgery. The cholelithiasis-free survival did not show statistical significance between the two groups (P = 0.267). The number needed to treat with PC to avoid reoperation for cholelithiasis was 1:32.5. Conclusions Concomitant PC during gastric surgery for malignancies, although reducing the absolute number of biliary abnormalities, has no significant impact on the natural course of patients.

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Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database

Cited by 20 publications

References 32 publications

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

Recent Change in Treatment of Disseminated Intravascular Coagulation in Japan

Analysis of gallstone disease after gastric cancer surgery

The Cholegas trial: long-term results of prophylactic cholecystectomy during gastrectomy for cancer—a randomized-controlled trial

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