Trends in cholecystectomy rates in a defined population during and after the period of transition from open to laparoscopic surgery

Talseth, Arne; Lydersen, Stian; Skjedlestad, FinnEgil; Hveem, Kristian; Edna, Tom-Harald

doi:10.3109/00365521.2013.853828

Cited by 26 publications

(15 citation statements)

References 21 publications

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“…Our finding of a 1:6 male to female ratio is in keeping with the literature albeit at a higher rate. Male patients were significantly older than female patients in this study which is also consistent with other cholecystectomy studies 11 . In period 2 of the study there was a significant trend for younger patients to have a cholecystectomy.…”

Section: Discussionsupporting

confidence: 93%

“…The increases from studies on cholecystectomy has ranged from 20 to 53% 11,13,15,16 . A continued and sustained increase in cholecystectomy rates are ascribed to changes in risk factors; specifically dietary changes and increasing body mass index 2,11,17 . South Africa has the highest prevalence of obesity in Sub-Saharan Africa with the highest incidence among black South African women 18 .…”

Section: Discussionmentioning

confidence: 99%

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Increases in cholecystectomy for gallstone related disease in South Africa

Khan

Brand

2020

Sci Rep

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Studies suggest that the rate gallstone disease in Africa is low. previous studies suggested an increase in gallstone rates and cholecystectomies related to urbanization and the adoption of Western lifestyle habits. this study examined cholecystectomy rates for gallstone disease in South Africa (SA). An audit of cholecystectomies in SA was done by reviewing gallbladder specimens processed by the SA National Health Laboratory Service (NHLS) from 2004 and 2014. Urbanization rates were obtained from Statistics South Africa and BMi data from previously published studies. fisher's exact test, t test's and pearson's R were used for comparisons; cholecystectomy rates were calculated per 100,000 population. 33,467 cholecystectomy specimens were analysed. There was a 92% absolute increase in cholecystectomies during the study period (Pearson r 0.94; p < 0.01) with the overall cholecystectomy rate increasing by 65% from 8.36 to 13.81 per 100,000 population. The data was divided into two equal periods and compared. During the second period there was a 28.8% increase in the number cholecystectomies and patients were significantly younger (46.9 vs 48.2 years; p ≤ 0.0001). The Northern Cape was the only province to show a decline in the cholecystectomy rate in this period and was also the only province to record a decline in urbanization. population based studies in SA demonstrate increases in BMi and an association with increased urbanization. this nationwide African study demonstrates a sustained increase in cholecystectomies for gallstone disease. increases in BMi and urbanization may be responsible for this trend. Gallbladder disease is a common and costly pathology. The development of gallstones varies among population groups around the world 1. In developed societies the rate of gallstone disease averages between 10 and 15%. The risk of developing symptomatic disease is approximately 2-3% per year and 10% five years after the development of stones 1. There is a causal association between changes in dietary intake, increases in body mass index (BMI) and symptomatic cholelithiasis 2. In the last thirty years the burden of disease has increased by more that 20% in the United States 1. In the paediatric population this increase has been attributed to increases in BMI 3. Population based studies have also identified an increased BMI as a risk factor for subsequent cholecystectomy 4. As a result the number of procedures for gallstone disease has risen with cholecystectomy becoming the most common elective surgical procedure in the United States 1. Two South African epidemiological studies completed during the 1980′s suggested that the rate of gallstone disease in the black "urban" African population was low 5,6. It was noted, however, that there was an increasing trend of patients with gallstone disease and the number of cholecystectomies being performed 5,6. An increasing exposure to a Western lifestyle was cited as the potential causal association. We hypothesized that the cholecystectomy rate for gallstone related disease h...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Increases in cholecystectomy for gallstone related disease in South Africa

Khan

Brand

2020

Sci Rep

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“…Before the era of laparoscopic surgery, the indication for cholecystectomy was one or more episodes of cholecystitis and gallstone‐related pain. However, following the introduction of laparoscopic surgery in later years, many have been offered surgery only after episodes of gallstone colic. In HUNT2, 32 per cent of the population did not participate.…”

Section: Discussionmentioning

confidence: 99%

“…Cholecystectomy rates in North America increased during the 1990s, probably explained by increased incidence of cholelithiasis, an increased frequency of symptomatic gallstone disease, improved diagnostic expertise and a lowered threshold for surgery. However, in the late 1990s the cholecystectomy rate stabilized following the introduction of the laparoscopic technique, as also demonstrated in Europe. In Nord‐Trøndelag County, Norway, the cholecystectomy rate increased during the years following introduction of laparoscopic surgery, from 6·2 per 100 000 person‐years in 1990–1992 to 10·0 per 100 000 in 1998–2003, and has remained stable since.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for requiring cholecystectomy for gallstone disease in a prospective population-based cohort study

Talseth

Ness-Jensen

Edna

et al. 2016

British Journal of Surgery

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BackgroundThe relationship between different lifestyle factors and the risk of needing cholecystectomy for gallstone disease is not clear. This study aimed to assess the association between anthropometric, lifestyle and sociodemographic risk factors and the subsequent risk of requiring cholecystectomy for gallstone disease during long‐term follow‐up in a defined population cohort.MethodsData from a large population‐based cohort study performed from 1995 to 1997 were used (the second Norwegian Nord‐Trøndelag health study, HUNT2). Following HUNT2, from 1998 to 2011, all patients operated on for gallstone disease with cholecystectomy at the two hospitals in the county, Levanger Hospital and Namsos Hospital, were identified. A Cox proportional hazards model was used for multivariable risk analysis.ResultsThe HUNT2 cohort included 65 237 individuals (69·5 per cent response rate), aged 20–99 years. During a median follow‐up of 15·3 (range 0·6–16·4) years, 1162 cholecystectomies were performed. In multivariable analysis, overweight individuals (body mass index (BMI) 25·0–29·9 kg/m2) had a 58 per cent increased risk of cholecystectomy compared with individuals with normal weight (BMI less than 25·0 kg/m2). Obese individuals (BMI 30 kg/m2 or above) had a twofold increased risk. Increasing waist circumference independently increased the risk of cholecystectomy. In women, current hormone replacement therapy (HRT) increased the risk, whereas hard physical activity and higher educational level were associated with reduced risk of cholecystectomy.ConclusionHigh BMI and waist circumference increased the risk of having cholecystectomy for both sexes. In women, the risk was increased by HRT, and decreased by hard physical activity and higher educational level.

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“…Laparoscopic cholecystectomy, which was introduced in 1985, 3 has markedly reduced the need for open cholecystectomy 4 and its attendant complications. 5 The procedure has become the standard treatment for symptomatic cholelithiasis and mild-to-moderate acute cholecystitis.…”

Section: Laparoscopic Approachmentioning

confidence: 99%