The impact of laparoscopic cholecystectomy on the treatment of symptomatic cholelithiasis

Abstract

The indication for surgery in cholelithiasis has not changed since the introduction of LC. In patients with symptomatic gallstones, early elective surgery is recommended and may be more cost-effective.

Mini‐cholecystectomy: a personal series in acute and chronic cholecystitis

“…Postoperative hospital stay in the present series was in agreement with other reports [5–8, 14, 19, 20], although in some centres, MC is now performed as day‐case or ambulatory surgery [21]. The results of MC in acute cholecystitis in this study compare favourably with those reported for LC [9, 16, 17], but the costs are lower [6, 21]. Avoiding the need for special instruments improves the cost‐effectiveness of MC.…”

“…In the emergency setting of acute cholecystitis, LC is gaining popularity rapidly and good results have been reported [16, 17]. However, the conversion rate to open cholecystectomy is still high, varying between 16% and 35% [16, 17].…”

“…In the emergency setting of acute cholecystitis, LC is gaining popularity rapidly and good results have been reported [16, 17]. However, the conversion rate to open cholecystectomy is still high, varying between 16% and 35% [16, 17]. By contrast, only a few studies on the applicability and efficacy of MC in acute cholecystitis have been published [18, 19].…”

Impact of laparoscopic cholecystectomy on indications for surgical treatment of gallstones

“…This trend has already eliminated the anticipated cost savings of laparoscopic cholecystectomy for the payors [4]. By contrast, Ho et al [7] in a study of cholecystectomy from 1988 to 1994 reported that their cholecystectomy rate had stabilized at a level only 11% higher than in the years preceding the introduction of laparoscopic cholecystectomy. This finding could be explained by the fact that theirs is a tertiary referral center and may not reflect what is happening in the country as a whole.…”

Cholecystectomy rates, gallstone prevalence, and handling of bile duct injuries in Scandinavia

“…Most of these reports describe permanently higher surgical rates, unlike the 20.8% increase in Sweden in 1992, which was followed by a gradual reduction during the next 3 years [5]. Even though reports on unaltered cholecystectomy rates have been published from North Carolina [18] and California [9], the indications for cholecystectomy may have changed in the United States and Australia, perhaps due to an increased acceptance of a procedure offering less postoperative pain and a shorter convalescence period. The increased rate of cholecystectomy is probably not appropriate because some patients might be better off with conservative treatment.…”