Increased rate of cholecystectomies performed with doubtful or no indications after laparoscopy introduction: a single center experience

BMC Surgery

Isidoro Di Carlo¹  Maurizio Mannino³  Michel Gagner²  Adriana Toro³  Elia Pulvirenti³ 

[1] Department of Surgical Sciences, Organ Transplantation, and Advanced Technologies, University of Catania, Cannizzaro Hospital, Via Messina 829, 95126, Catania, Italy;Department of Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA;Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Catania, Italy

关键词: Laparoscopy;    Surgical indications;    Gallbladder stones;    Open cholecystectomy;    Laparoscopic cholecystectomy;   

Others  :  866925
DOI  :  10.1186/1471-2482-13-17

 received in 2012-09-17, accepted in 2013-05-22,  发布年份 2013

【 摘 要 】

Background

During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes.

Methods

831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed.

Results

At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic cholecystitis; 14.68% were operated on because of an increase in bilirubin level; 1.56% were operated on because of a previous episode of jaundice with normal bilirubin at admission; 0.72% had gallbladder adenomas, 0.72% had cholangitis, 0.36% had biliodigestive fistula and one patient (0.12%) had acalculous cholecystitis. By excluding all these patients, 21.18% were operated on without indications.

Conclusions

The broadening of indications for laparoscopic cholecystectomy is undisputed and can be considered a consequence of new technologies that have been introduced, increased demand from patients, and the need for practice by inexperienced surgeons. If not prevented, this trend could continue indefinitely.

【 授权许可】

   
2013 Pulvirenti et al.; licensee BioMed Central Ltd.

【 图 表 】

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