Article

Surgical Endoscopy

, Volume 27, Issue 9, pp 3254-3261

First online:

Time trend and variability of open versus laparoscopic cholecystectomy in patients with symptomatic gallstone disease

  • Mario SaiaAffiliated withVeneto Region Health Directorate
  • , Domenico MantoanAffiliated withVeneto Region Health Directorate
  • , Alessandra BujaAffiliated withLaboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua Email author 
  • , Chiara BertoncelloAffiliated withLaboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua
  • , Tatjana BaldovinAffiliated withLaboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua
  • , Giampietro CallegaroAffiliated withVeneto Region Local Health Unit n. 8
  • , Vincenzo BaldoAffiliated withLaboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Background

The purpose of this study was to compare length of stay, as one of the efficacy indicators, and effectiveness, in terms of operative complications and mortality, between laparoscopic (LC) and open cholecystectomy, and to verify the 10-year temporal trends in the application of the LC technique in a large regional population.

Methods

This was a retrospective cohort study based on 73,853 hospital discharge records of cholecystectomies for gallstone disease (GD) in residents of the Veneto from 2001 to 2010, at both public and accredited private hospitals. The data are from a regional administrative database. The main epidemiological rates calculated, and expressed per 100,000 residents, were the cholecystectomy rate (CR) for gallstones by surgical technique (laparoscopic or open surgery), and the in-hospital mortality rate (MR), considered as the in-hospital MR regardless of the specific cause of death.

Results

The CR was 139.7 higher in females, with a male-to-female ratio of 1:1.5. LC was performed more frequently in females than in males and in younger than in older patients. From 2001 to 2010, there was a significant linear rising trend in the use of LC, in fact during the period considered, the use of laparoscopic surgery increased significant (χ 2 trend: 316,917; p < 0.05), reaching 93.6 % of surgical procedures for gallstones during the year 2010.

Conclusions

There are still some age- and gender-related disparities in its usage, although LC is an increasingly widely applied, as effective procedure.

Keywords

Cholecystitis Health care surveys Disease management Delivery of health care Surgical approach