Regional variations in cholecystectomy rates in Sweden: impact on complications of gallstone disease

Noel, Rozh; Arnelo, Urban; Enochsson, Lars; Lundell, Lars; Nilsson, Magnus; Sandblom, Gabriel

doi:10.3109/00365521.2015.1111935

Cited by 12 publications

(8 citation statements)

References 175 publications

(254 reference statements)

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“…The cholecystectomy rate varies geographically, but is generally undertaken in between 100 to 200 per 100,000 inhabitants [23]. In the UK, 41% of patients have been admitted with prior cholecystitis before their eventual cholecystectomy [24].…”

Section: Discussionmentioning

confidence: 99%

Intra-operative gallbladder scoring predicts conversion of laparoscopic to open cholecystectomy: a WSES prospective collaborative study

Sugrue

Catena

Bucholc³

et al. 2019

World J Emerg Surg

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IntroductionLaparoscopic cholecystectomy, the gold-standard approach for cholecystectomy, has surprisingly variable outcomes and conversion rates. Only recently has operative grading been reported to define disease severity and few have been validated. This multicentre, multinational study assessed an operative scoring system to assess its ability to predict the need for conversion from laparoscopic to open cholecystectomy.MethodsA prospective, web-based, ethically approved study was established by WSES with a 10-point gallbladder operative scoring system; enrolling patients undergoing elective or emergency laparoscopic cholecystectomy between January 2016 and December 2017. Gallbladder surgery was considered easy if the G10 score < 2, moderate (2 ≦ 4), difficult (5 ≦ 7) and extreme (8 ≦ 10). Demographics about the patients, surgeons and operative procedures, use of cholangiography and conversion rates were recorded.ResultsFive hundred four patients, mean age 53.5 (range 18–89), were enrolled by 55 surgeons in 16 countries. Surgery was performed by consultants in 70% and was elective in (56%) with a mean operative time of 78.7 min (range 15-400). The mean G10 score was 3.21, with 22% deemed to have difficult or extreme surgical gallbladders, and 71/504 patients were converted. The G10 score was 2.98 in those completed laparoscopically and 4.65 in the 71/504 (14%) converted. (p < 0.0001; AUC 0.772 (CI 0.719–0.825). The optimal cut-off point of 0.067 (score of 3) was identified in G10 vs conversion to open cholecystectomy. Conversion occurred in 33% of patients with G10 scores of ≥ 5. The four variables statistically predictive of conversion were GB appearance—completely buried GB, impacted stone, bile or pus outside GB and fistula.ConclusionThe G10 operative scores provide simple grading of operative cholecystectomy and are predictive of the need to convert to open cholecystectomy. Broader adaptation and validation may provide a benchmark to understand and improve care and afford more standardisation in global comparisons of care for cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Intra-operative gallbladder scoring predicts conversion of laparoscopic to open cholecystectomy: a WSES prospective collaborative study

Sugrue

Catena

Bucholc³

et al. 2019

World J Emerg Surg

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“…A recent nationwide study from Sweden, which assessed a total of 130,800 laparoscopic and 47,641 open cholecystectomies performed between 1998 and 2013, showed the annual rates of cholecystectomies remained stable. 34 In contrast, our data covering all cholecystectomies performed within the Netherlands between 1991 and 2015 indicates annual rates have increased between 1991 and 2007 and remained relatively stable with a minimal decline after 2012. This corresponds with the observed increase in probability of cholecystectomy after IR in our study population.…”

Section: Discussionmentioning

confidence: 69%

“…However, in general, only a small proportion of patients undergo cholecystectomy for these indications. 34…”

Section: Discussionmentioning

confidence: 99%

Cholecystectomy Risk in Crohn’s Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study

Goet

Beelen

Biermann

et al. 2019

Journal of Gastrointestinal Surgery

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Background The risk of gallstone disease necessitating cholecystectomy after ileal resection (IR) in Crohn’s disease (CD) patients is not well established. We studied the incidence, cumulative and relative risk of cholecystectomy after IR in CD patients, and associated risk factors. Methods CD patients with a first IR between 1991 and 2015 were identified in PALGA, a nationwide pathology database in the Netherlands. Details on subsequent cholecystectomy and IR were recorded. Yearly cholecystectomy rates from the general Dutch population were used as a reference. Results A cohort of 8302 (3466 (41.7%) males) CD patients after IR was identified. During the 11.9 (IQR 6.3–18.0) years median follow-up, the post-IR incidence rate of cholecystectomy was 5.2 (95% CI 3.5–6.4)/1000 persons/year. The cumulative incidence was 0.5% at 1 year, 2.4% at 5 years, 4.6% at 10 years, and 10.3% after 20 years. In multivariable analyses, female sex (HR 1.9, CI 1.5–2.3), a later calendar year of first IR (HR /5-year increase , HR 1.27, CI 1.18–1.35), and ileal re-resection (time-dependent HR 1.37, CI 1.06–1.77) were associated with cholecystectomy. In the last decade, cholecystectomy rates increased and were higher in our postoperative CD population than in the general population (relative incidence ratio 3.13 (CI 2.29–4.28; p < 0.0001) in 2015). Conclusions Although higher in females, increasing in recent years, and higher than in the general population, the overall risk of cholecystectomy in CD patients following IR is low and routine prophylactic measures seem unwarranted. Electronic supplementary material The online version of this article (10.1007/s11605-018-4028-y) contains supplementary material, which is available to authorized users.

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“…Un estudio realizado por Bray et al 12 , encontró un volumen de colecistectomías de 182,6 por 100.000 habitantes en Francia, en un periodo de 7 años, mientras que en Suecia se estimó una media de 157 cirugías por 100.000 habitantes en un periodo de 5 años 13 . El volumen quirúrgico hallado en este estudio en los 5 años estimados fue de 206 colecistectomías por 100.000 afiliados, cifra que comparada con los dos estudios mencionados anteriormente, es mayor.…”

Section: Discussionunclassified

Mortalidad perioperatoria y volumen quirúrgico de colecistectomías en el régimen contributivo en Colombia

2021

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Introducción. La patología biliar es una causa frecuente de intervención quirúrgica, Pero en Colombia no se cuenta con datos oficiales de mortalidad ni volumen quirúrgico asociados a este procedimiento. El objetivo de este estudio fue determinar el volumen de colecistectomías y describir la tasa general de mortalidad perioperatoria en seis regiones geográficas del país, en el periodo de 2012 a 2016. Métodos. Estudio de cohortes retrospectivo que incluyó pacientes mayores de 18 años, afiliados al régimen contributivo de salud, llevados a colecistectomía. Se utilizó la base de datos de suficiencia de la Unidad de Pago por Capitación (UPC), la base de estadísticas vitales del Departamento Administrativo Nacional de Estadística (DANE) y la del Sistema Integrado de Información de la Protección Social (SISPRO). Resultados. Durante el periodo de estudio, se realizaron 192.080 colecistectomías, lo que corresponde a 206 colecistectomías por 100.000 habitantes. Se encontró mayor volumen quirúrgico en personas entre los 65 y 80 años, en el sexo femenino y en la ciudad de Bogotá. La mortalidad perioperatoria encontrada correspondió al 0,6 %, siendo mayor en los pacientes de sexo masculino, de edad avanzada, en aquellos en quienes se practicó laparotomía y en los pacientes operados en la ciudad de Bogotá. Discusión. De acuerdo con los hallazgos, esta investigación puede servir de base para estudios posteriores, que muestren claramente las cifras oficiales de volumen quirúrgico y de mortalidad por colecistectomía en Colombia.

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Regional variations in cholecystectomy rates in Sweden: impact on complications of gallstone disease

Abstract: There are wide regional variations in cholecystectomy rates in Sweden. The present study does not give support that frequent use of cholecystectomy in uncomplicated gallstone disease prevents future gallstone complications.

Cited by 12 publications

References 175 publications

Intra-operative gallbladder scoring predicts conversion of laparoscopic to open cholecystectomy: a WSES prospective collaborative study

Intra-operative gallbladder scoring predicts conversion of laparoscopic to open cholecystectomy: a WSES prospective collaborative study

Cholecystectomy Risk in Crohn’s Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study

Mortalidad perioperatoria y volumen quirúrgico de colecistectomías en el régimen contributivo en Colombia

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