Increased rate of cholecystectomies performed with doubtful or no indications after laparoscopy introduction: a single center experience.
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| Abstract | 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.
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| Authors | Elia Pulvirenti, Adriana Toro, Michel Gagner, Maurizio Mannino, Isidoro Di Carlo |
| Journal | BMC surgery (BMC Surg) Vol. 13 Pg. 17 (May 31 2013) ISSN: 1471-2482 [Electronic] England |
| PMID | 23724992 (Publication Type: Journal Article) |
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