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Management of acute gallbladder disease in England
G G David1, A A Al-Sarira, S Willmott
1Leighton Research Unit, Department of General Surgery, Crewe, UK.
The British Journal of Surgery
|October 31, 2007
Summary
Early cholecystectomy for acute gallbladder disease is not common in England. Open cholecystectomy is preferred in emergencies, with laparoscopic surgery showing a higher conversion rate in this setting.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Health Services Research
Background:
- Evidence suggests early laparoscopic cholecystectomy is safe and effective for acute gallbladder disease.
- Limited data exist on current management practices in England.
Purpose of the Study:
- To analyze the practice of early cholecystectomy for acute gallbladder disease in England.
- To compare open versus laparoscopic cholecystectomy rates and outcomes in emergency and elective settings.
Main Methods:
- Utilized Hospital Episode Statistics data from 2003-2005.
- Included patients admitted with acute gallbladder disease from April 2003 to March 2004.
- Followed up on repeat admissions and cholecystectomies until March 2005.
Main Results:
- 25,743 patients admitted with acute gallbladder disease.
- Emergency cholecystectomy: 3791 cases (29.8% open, 10.7% laparoscopic conversion rate).
- Elective cholecystectomy: 9806 cases (11.3% open, 8.3% laparoscopic conversion rate).
Conclusions:
- Early cholecystectomy for acute gallbladder disease is underutilized in England.
- Open cholecystectomy is more prevalent in emergency settings compared to elective.
- Laparoscopic cholecystectomy post-emergency admission has a higher conversion rate than elective procedures.
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