Increased Rate of Cholecystectomy after Introduction of Laparoscopic Cholecystectomy in Saudi Arabia

Abstract

A rapid increase in the rate of cholecystectomy was reported in eastern Saudi Arabia between 1977 and 1986. The aim of this study was to determine whether the rate of cholecystectomy in the same region was still rising after the introduction of laparoscopic cholecystectomy. From 1987 to 1995 a total of 24 hospitals in eastern Saudi Arabia were surveyed using a questionnaire. During the 9-year study period, the rate of total cholecystectomy (open and laparoscopic) increased by 91%. Whereas the cholecystectomy rate decreased by 4% per annum from 1987 to 1990, it increased by 63.7% from 1991 to 1995 after the introduction of laparoscopic cholecystectomy. The increase in the rates of cholecystectomy was observed in all age groups and both sexes. Cholecystectomy was, however, most frequent among the age group 45-64 years followed by the age group 25-44 years. Young and female patients were more likely to undergo laparoscopic cholecystectomy than the open procedure. The rise in cholecystectomy rate deserves further evaluation with regard to the following: reasons for the increased rate of cholecystectomy, cholecystectomy-related morbidity and mortality, and the total costs of cholecystectomy.

Increased cholecystectomy rate in the laparoscopic era

“…One change that has been noted in many centers is an apparent increase in the number of cholecystectomies performed since the start of the laparoscopic era [1,6,12,19]. This reported increase has varied significantly: Lam et al [12] described an increase of 18.7% between 1989 and 1993 in Scotland, whereas a study of patients in New York by Legoretta et al [13] found an increase of 57% between 1988 and 1992.…”

“…Several centers have reported an increase in the cholecystectomy rate since the introduction of the laparoscopic technique [1,4,6,12,15]. There are a number of possible explanations for this reported increase.…”

A survey of surgical management of acute cholecystitis in eastern Saudi Arabia

“…[27] Previous reports from our institution have indicated that early LC for AC is safe, with a low rate of conversion to open cholecystectomy, few complications, and no mortality. [128]…”

Post-cholecystectomy diarrhoea: a running commentary

“…2 This has occurred despite a lack of evidence that gallstone incidence has increased to the same degree. Laparoscopic cholecystectomy has a lower mortality rate than open cholecystectomy, but in view of the increased cholecystectomy rate, there may be no decrease in the total number of deaths associated with this operation 1.…”