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Development of gallstone surgery in Germany.

H Krämling¹, T P Hüttl, G Heberer

¹Department of Surgery, University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, 81377 München, Germany.

Surgical Endoscopy

|August 18, 1999

Summary

Laparoscopic gallstone surgery in Germany shows a positive trend with decreasing complications and morbidity, indicating improved training and experience. Common bile duct injuries have also peaked and are declining.

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Area of Science:

Gastroenterology
Surgical Innovation
Public Health

Background:

Nationwide survey on laparoscopic gallstone surgery in Germany.
Assesses development and outcomes of the procedure.

Purpose of the Study:

Evaluate the evolution and results of laparoscopic cholecystectomy in Germany.
Analyze trends in morbidity, mortality, and complications.

Main Methods:

Annual questionnaire survey from 1991-1994 to 449 German surgeons.
Collected data on 72,455 gallstone disease operations.
Included diagnostic/therapeutic approaches, procedures, complications, and mortality.

Main Results:

Laparoscopic cholecystectomy use rose from 24.9% (1991) to 92% (1994).

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Morbidity (6% vs. 9%) and mortality (0.14-0.45%) were lower than open surgery.

Common bile duct injuries were higher initially (0.7% vs. 0.4%) but decreased by 1993.

Conclusions:

Demonstrates a learning curve for laparoscopic cholecystectomy in Germany.
Improved training and experience led to reduced overall risk.
Incidence of common bile duct injuries and technical issues has peaked and is declining.