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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.
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).
- 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.