OutcomeTrends in surgical management for acute cholecystitis
Section snippets
Materials and methods
We used the NIS for the years 1998 to 2005 to extract data for all patients with AC. The NIS is the largest national, all-payer, hospital inpatient care database in the United States. It is supported by the Healthcare Cost and Utilization Project and contains all-payer discharge information for 100% of patient discharges from participating hospitals. Data exist for approximately seven million hospital discharges per year from a stratified sample of 20% of nonfederal U.S. community hospitals
Demographics
From approximately 1.8 million admissions for AC, 1.4 million patients (76%) underwent cholecystectomy (1,240,212 LC; 147,190 OC) for AC from 1998 to 2005. The number of patients admitted with AC and subsequently the number of cholecystectomies performed for AC increased over time. When examined by year, the rate of cholecystectomy (LC or OC) remained constant throughout the course of the study (76%). The ratio of LC performed increased from 83% in 1998 to 93% in 2005 (Fig 1).
Demographic
Discussion
Acute cholecystitis in the current era is usually treated with cholecystectomy with excellent results and patient outcomes. Since the advent of laparoscopy, the indications and use of LC have expanded. We are now 20 years removed from the first LC and important questions concerning current safety, new indications, and outcomes need to be addressed for AC.
The results of this population-based study confirm that the diagnosis and treatment of AC with operative treatment is increasing. Over the
References (22)
- et al.
A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy
Am J Gastroenterol
(2002) - et al.
A nationwide study of conversion from laparoscopic to open cholecystectomy
Am J Surg
(2004) - et al.
Early decision for conversion of laparoscopic to open cholecystectomy for treatment of acute cholecystitis
Am J Surg
(1997) - et al.
Laparoscopic and open cholecystectomy in New York State: mortality, complications, and choice of procedure
Surgery
(1999) - et al.
Impact of laparoscopic cholecystectomy: a population-based study
Lancet
(2000) - et al.
Survival after liver resection for metastatic colorectal carcinoma in a large population
J Am Coll Surg
(2007) - et al.
Surgical education: the new generation
J Surg Educ
(2007) - et al.
The impact of a formal minimally invasive service on the resident's ability to achieve new ACGME guidelines for laparoscopy
J Surg Educ
(2007) - et al.
Factors associated with successful laparoscopic cholecystectomy for acute cholecystitis
Ann Surg
(1993) - et al.
Laparoscopic cholecystectomy: the procedure of choice for acute cholecystitis
Am J Gastroenterol
(1993)
Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy
JAMA
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Presented at the 3rd Annual Academic Surgical Congress, Huntington Beach, California, February 2008.