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Mortality Associated with the Treatment of Gallstone Disease: A 10-Year Contemporary National Experience

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Abstract

Background

Gallstones remain a common clinical problem requiring skilled operative and nonoperative management. The aim of the present population-based study was to investigate causes of gallstone-related mortality in Scotland.

Methods

Surgical deaths were peer reviewed between 1997 and 2006 through the Scottish Audit of Surgical Mortality (SASM); data were analyzed for patients in whom the principal diagnosis on admission was gallstone disease.

Results

Gallstone disease was responsible for 790/43,271 (1.83%) of the surgical deaths recorded, with an overall mortality for cholecystectomy of 0.307% (176/57,352), endoscopic retrograde cholangiopancreatography (ERCP) of 0.313% (117/37,345), and cholecystostomy of 2.1% (12/578) across the decade. However, the majority of patients who died were elderly (47.6% ≥80 years or older) and were managed conservatively. Deaths following cholecystectomy usually followed emergency admission (76%) and were more likely to have been associated with postoperative medical complications (n = 189) than surgical complications (n = 36).

Discussion

Although cholecystectomy is a relatively safe procedure, patients who die as a result of gallstone disease tend to be elderly, to have been admitted as emergency cases, and to have had co-morbidities. Future combined medical and surgical perioperative management may reduce the mortality rate associated with gallstones.

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Acknowledgments

The authors thank Dave Stobie, David Readhead, Christine Torrance, and Lynsey Kerr from the Information Services Division of the National Health Service (NHS), National Services Scotland, for assistance with this research. They also acknowledge the assistance of Mr. Jamie Young, Department of Surgery, Ninewells Hospital, for help with statistical analysis.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Ninewells Hospital and Medical School, Dundee, D1 9SY, UK

    John M. Scollay, Russell Mullen & Alastair M. Thompson

  2. Scottish Audit of Surgical Mortality, Second Floor, Cirrus Building, Marchburn Drive, Paisley, PA3 2SJ, UK

    Gillian McPhillips & Alastair M. Thompson

  3. Department of Surgical Oncology, MD Anderson Cancer Center, 1400 Holcombe Boulevard, Houston, TX, 77030, USA

    Alastair M. Thompson

Authors
  1. John M. Scollay
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  2. Russell Mullen
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  3. Gillian McPhillips
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  4. Alastair M. Thompson
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Correspondence to John M. Scollay.

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Scollay, J.M., Mullen, R., McPhillips, G. et al. Mortality Associated with the Treatment of Gallstone Disease: A 10-Year Contemporary National Experience. World J Surg 35, 643–647 (2011). https://doi.org/10.1007/s00268-010-0908-3

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