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 20 February 2018

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News

Cholecystectomy increased over the last 2 decades

During the 1990s, cholecystectomy incidence increased, whereas postoperative mortality risk remained unchanged, reports December's Scandanavian Journal of Gastroenterology.

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Information on mortality after cholecystectomy in defined populations is limited.

Dr Erik Nilsson and colleagues from Sweden examined the case fatality rates and mortality ratios, based on register data.

Hospital discharge and death certificate data were linked for all patients undergoing cholecystectomy from 1987 to 1999.

The researchers calculated mortality risk as the standardized mortality ratio.

The research team noted that 123,099 patients underwent cholecystectomy for acute or chronic gallbladder disease.

The team found that the incidence of cholecystectomy increased by 13%, the median age of patients decreased and the proportion of women increased.

Biliary tract diseases accounted for 61% of all postoperative deaths
Scandanavian Journal of Gastroenterology

From 1995 to 1999, 32% of all cholecystectomies were completed as open cholecystectomy.

During this period, the team noted that 82% of patients aged 70 years or older with acute gallstone disease had an open cholecystectomy.

For patients with chronic gallstone disease, the proportion was 43%.

The researchers observed that postoperative crude mortality within 30 days for all patients was 0.4%.

Patients with acalculous gallbladder disease had double the mortality risk compared with patients with calculous disease.

Patients with acute cholecystitis had double the risk compared with patients with chronic disease.

The researchers found that high age, previous hospital admission for conditions other than gallbladder disease, increased the risk.

In addition, cholecystectomy completed as an open procedure increased the risk.

However, the team noted that gender and calendar year did not significantly affect the mortality risk.

Biliary tract diseases accounted for 61% of all postoperative deaths, whereas 26% were due to cardiovascular diseases.

Dr Nilsson's team commented, “During the 1990s, cholecystectomy incidence increased, whereas postoperative mortality risk remained unchanged.”

“In order to further reduce the mortality risk, particular attention should be paid to elderly and frail patients and to patients with acalculous gallbladder disease.”

Scand J Gastroenterol 2005: 40(12): 1478-85
23 November 2005

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